ABSTRACT
We report the case of a 20-year-old man with acne conglobata (AC) who was treated with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) sequentially to deroofing, and finally used fractional carbon dioxide laser for esthetic requirements, achieving satisfying results. AC is a severe form of acne vulgaris that can lead to significant scarring and has serious negative effects on a patient's psychological well-being and quality of life. Some cases are likely resistant to currently available treatments. This report describes a promising, and effective method for the treatment of AC.
Subject(s)
Acne Conglobata , Acne Vulgaris , Photochemotherapy , Acne Conglobata/drug therapy , Acne Vulgaris/drug therapy , Adult , Aminolevulinic Acid/therapeutic use , Humans , Male , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Quality of Life , Treatment Outcome , Young AdultSubject(s)
Acne Conglobata/drug therapy , Acne Vulgaris/drug therapy , Dermatologic Agents/therapeutic use , Isotretinoin/therapeutic use , Acne Conglobata/pathology , Acne Vulgaris/pathology , Animals , Cysts/pathology , Dermatologic Agents/administration & dosage , Dermatologic Agents/history , History, 20th Century , Humans , Isotretinoin/administration & dosage , Isotretinoin/history , Mice , Models, Animal , Papilloma/chemically induced , Papilloma/drug therapy , Placebo Effect , Skin Neoplasms/prevention & control , Vitamin A/chemistrySubject(s)
Acne Conglobata/drug therapy , Adalimumab/administration & dosage , Minocycline/administration & dosage , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Acne Conglobata/pathology , Adolescent , Anti-Inflammatory Agents/administration & dosage , Drug Therapy, Combination , Humans , Injections, Subcutaneous , MaleSubject(s)
Acne Conglobata/complications , Scleritis/complications , Vision Disorders/etiology , Acne Conglobata/drug therapy , Acne Conglobata/pathology , Dermatologic Agents/administration & dosage , Dermatologic Agents/therapeutic use , Humans , Isotretinoin/administration & dosage , Isotretinoin/therapeutic use , Male , Scleritis/diagnosis , Scleritis/pathology , Treatment Outcome , Vision Disorders/diagnosis , Young AdultABSTRACT
Acne fulminans is an uncommon and debilitating disease that presents as an acute eruption of nodular and ulcerative acne lesions in association with systemic symptoms. It occurs commonly during treatment of severe acne (eg, acne conglobata) with isotretinoin in young adolescent male patients. Isotretinoin and doxycycline also can potentially induce development of neutrophilic dermatoses in patients with severe acne lesions, which are characterized by the acute appearance of painful ulcerative papulonodules accompanied by systemic symptoms including fever and leukocytosis. We report a challenging case of a 13-year-old adolescent boy who acutely developed hundreds of ulcerative plaques as well as systemic symptoms after being treated with doxycycline and isotretinoin for acne conglobata. He was treated with prednisone, dapsone, and colchicine and had to switch to cyclosporine to achieve relief from his condition.
Subject(s)
Acne Conglobata/drug therapy , Doxycycline/adverse effects , Isotretinoin/adverse effects , Skin Ulcer/chemically induced , Adolescent , Colchicine/administration & dosage , Cyclosporine/administration & dosage , Dapsone/administration & dosage , Dermatologic Agents/administration & dosage , Dermatologic Agents/adverse effects , Doxycycline/administration & dosage , Humans , Isotretinoin/administration & dosage , Male , Neutrophils/metabolism , Prednisone/administration & dosage , Skin Ulcer/pathologyABSTRACT
Acne conglobata (AC) is a chronic, severe, inflammatory variant of acne characterized by development of cystic nodules, abscesses and sinus tracts. AC may prove resistant to conventional acne therapy. The off-label use of adalimumab for the treatment of AC has been reported recently. We present a 26-year-old man with AC resistant to conventional treatment, who was treated with 40 mg adalimumab every other week, with significant clinical improvement. We review the evidence for the use of tumour necrosis factor antagonists in AC and related conditions. This case provides further evidence supporting the role of adalimumab in the treatment of AC.
