From Wikipedia, the free encyclopedia
Medical condition
Acne fulminans
(also known as "
acute febrile ulcerative acne
"
[1]
: 686
) is a severe form of the skin disease,
acne
, which can occur after unsuccessful treatment for another form of acne,
acne conglobata
. The condition is thought to be an immunologically induced disease in which elevated level of
testosterone
causes a rise in sebum and population of
Cutibacterium acnes
bacteria. The increase in the amount of
C acnes
or related antigens may trigger the immunologic reaction in some individuals and lead to an occurrence of acne fulminans.
[2]
In addition to testosterone,
isotretinoin
may also precipitate acne fulminans, possibly related to highly increased levels of
C acnes antigens
in the patient's immune system.
[3]
Acne fulminans is a rare disease. Over the past several years, fewer cases of this disease have occurred, possibly because of earlier and better treatment of acne. Approximately 100 patients with acne fulminans have been described.
[4]
Signs and symptoms
[
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]
Acne fulminans begins as pain and inflammation in the joints.
[5]
It eventually progresses into a swelling of the lymph nodes located at the base of the neck, causing inflexibility in the neck within weeks after the nodes swell. This swelling will eventually decrease, but this decrease will be accompanied by an increased inflammation and swelling of the joints, as well as a complete loss of appetite, though these symptoms are often ignored. After some time, the disease will cause an extreme loss of weight and atrophy of the muscles, leading to the decline of physical abilities.
[6]
Outcome and treatment
[
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]
There is limited evidenced-based data concerning the treatment of AF.
[7]
Treatment should be sought immediately in order to avoid hospitalization. If not treated, hospitalization for an extended period of time (usually two weeks) is likely.
[8]
During hospitalization, the patient is tested for signs of system degradation, especially of the skeletal structure and the digestive tract. By this time open sores will develop on the upper torso. Some will be the size of dimes, others will be large enough to stick a couple fingers into. They will crust up, causing cohesion to any fabric the sores touch, which is extremely painful to remove. It is recommended to sleep on one's sides until the cystic condition subsides, in order to avoid any uncomfortable situations.
Debridement
and
immunosuppressant
drugs (e.g
prednisone
) are preferred over
antibiotics
.
[9]
Recurrent AF is extremely rare. Bone lesions typically resolve with treatment, but residual radiographic changes, such as sclerosis and hyperostosis, may remain. Scarring and fibrosis may result from this acute inflammatory process. The disease activates at the height of puberty, usually at around 13 years of age. Acne fulminans predominantly affects young Hispanic White males aged 13 to 22 years with a history of acne. Studies have found successful treatment with Antimicrobial Agents and Oral Prednisolone.
[10]
History
[
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]
In 1958, at a meeting of the Detroit Dermatological Society, Burns and Colville presented a 16-year-old white boy with acute febrile disease and acne conglobata. Many similar cases have been reported since then.
[11]
Genetic factors may play an important role in some patients; 4 sets of identical twins who developed an identical pattern of acne fulminans have been documented.
[12]
See also
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]
References
[
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]
- ^
Freedberg, et al. (2003).
Fitzpatrick's Dermatology in General Medicine
. (6th ed.). McGraw-Hill.
ISBN
0-07-138076-0
.
- ^
Heydenreich, G. (1989).
"Testosterone and anabolic steroids and acne fulminans"
.
Archives of Dermatology
.
125
(4): 571?2.
doi
:
10.1001/archderm.1989.01670160119036
.
ISSN
0003-987X
.
PMID
2522757
.
- ^
Wollina, U.; Gesina, H.; Koch, A.; Kostler, E. (2005).
"Case reports: acne fulminans in Marfan syndrome"
.
J Drugs Dermatol
.
4
(4): 501?5.
ISSN
1545-9616
.
PMID
16004026
.
- ^
Zaba, R.; Schwartz, R.; Jarmuda, S.; Czarnecka-Operacz, M.; Silny, W. (2011).
"Acne fulminans: explosive systemic form of acne"
.
Journal of the European Academy of Dermatology and Venereology
.
25
(5): 501?7.
doi
:
10.1111/j.1468-3083.2010.03855.x
.
ISSN
1468-3083
.
PMID
21029206
.
S2CID
657256
.
- ^
Zaenglein, Andrea L.; Graber, Emmy M.; Thiboutot, Diane M. (2019), Kang, Sewon; Amagai, Masayuki; Bruckner, Anna L.; Enk, Alexander H. (eds.),
"Acne Variants and Acneiform Eruptions"
,
Fitzpatrick's Dermatology
(9 ed.), New York, NY: McGraw-Hill Education
, retrieved
2022-03-26
- ^
WINDOM RE; SANFORD JP; ZIFF M (1961).
"Acne conglobata and arthritis"
.
Arthritis & Rheumatism
.
4
(6): 632?5.
doi
:
10.1002/art.1780040609
.
ISSN
0004-3591
.
PMID
14007467
.
- ^
Greywal, Tanya; Zaenglein, Andrea L.; Baldwin, Hilary E.; Bhatia, Neal; Chernoff, Karen A.; Rosso, James Q. Del; Eichenfield, Lawrence F.; Levin, Marc H.; Leyden, James J.; Thiboutot, Diane M.; Webster, Guy F. (2017-07-01).
"Evidence-based recommendations for the management of acne fulminans and its variants"
.
Journal of the American Academy of Dermatology
.
77
(1): 109?117.
doi
:
10.1016/j.jaad.2016.11.028
.
ISSN
0190-9622
.
PMID
28619551
.
S2CID
205514693
.
- ^
Alakeel, Abdullah; Ferneiny, Marie; Auffret, Nicole; Bodemer, Christine (November 2016).
"Acne Fulminans: Case Series and Review of the Literature"
.
Pediatric Dermatology
.
33
(6): e388?e392.
doi
:
10.1111/pde.12983
.
PMID
27699859
.
S2CID
31943912
.
- ^
Iqbal, M.; Kolodney, M. S. (2005).
"Acne fulminans with synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome treated with infliximab"
.
J Am Acad Dermatol
.
52
(5 Suppl 1): S118-20.
doi
:
10.1016/j.jaad.2004.09.006
.
ISSN
1097-6787
.
PMID
15858507
.
- ^
Siadat, Amir Hossein; Bostakian, Anis; Abtahi-Naeini, Bahareh; Shahbazi, Masoom (2017).
"Successful Treatment of Facial Acne Fulminans: Antimicrobial Agents and Oral Prednisolone as Promising Regimes"
.
Case Reports in Dermatological Medicine
.
2017
: 7092910.
doi
:
10.1155/2017/7092910
.
ISSN
2090-6463
.
PMC
5385906
.
PMID
28428896
.
- ^
Burns RE, Colville JM (1959). "Acne conglobata with septicemia".
Arch. Dermatol
.
79
: 361.
- ^
Palatsi, R.; Oikarinen, A. (1979).
"Hormonal analysis and delayed hypersensitivity reactions in identical twins with severe acne"
.
Acta Derm Venereol
.
59
(2): 157?60.
ISSN
0001-5555
.
PMID
84495
.
External links
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