Presentation
The systemic findings seen in acne fulminans are not present. [en.wikipedia.org]
The present study is constrained by several limitations. [biomeddermatol.biomedcentral.com]
Enhancing Healthcare Team Outcomes Patients with acne usually present to their primary care provider or nurse practitioner. [ncbi.nlm.nih.gov]
A 34 year-old white male presented with chronic, large, numerous, painful draining cysts of the trunk, groin and neck of ten years duration. The patient reported excessive alcohol ingestion and suicidal thoughts due to the pain. [dialnet.unirioja.es]
Entire Body System
- Amyloidosis
Acute anterior uveitis, [6] renal amyloidosis [7] and IgA gammopathy [8] have been reported with AC. The primary cause of AC remains unknown. [ijdvl.com]
Hidradenitis suppurativa resulting in systemic amyloid A amyloidosis: a case report and review of the literature. Dermatol Online J. 2012;18:2. PubMed Google Scholar Housman E, Reynolds RV. [biomeddermatol.biomedcentral.com]
Renal amyloidosis has been reported[20]. Scars remain for life. Prognosis[8] The disease has a chronic course, leading to extensive scarring and psychological distress. [patient.info]
Renal amyloidosis secondary to acne conglobata. Int J Dermatol. 1989 Mar. 28(2):132-3. [QxMD MEDLINE Link]. Freira S, Fonseca H, Ferreira PD, Vasconcelos P, Fonseca JE. [emedicine.medscape.com]
- Pseudotumor
Oral tetracycline antibiotics should not be combined with oral isotretinoin because of an increased risk of pseudotumor cerebri. [tibot.ai]
The tetracyclines should not be combined with oral isotretinoin because there is a real potential to induce pseudotumor cerebri. In cases which are unresponsive to the above antibiotics, dapsone is an option. [statpearls.com]
The tetracyclines should not be combined with oral isotretinoin because there is a real potential to induce pseudotumor cerebri. In cases that are unresponsive to the above antibiotics, dapsone is an option. [ncbi.nlm.nih.gov]
Pseudotumor cerebri is a rare side effect seen with the tetracyclines as well. Rare hypersensitivity reactions including serum sickness-like reaction and DRESS syndrome have been reported. [dermatologyadvisor.com]
- Constitutional Symptom
It is a systemic disease of unknown etiology characterized by necrotizing acne associated with constitutional symptoms and laboratory abnormalities. [nature.com]
Steroids have been shown to be effective when there are systemic constitutional symptoms such as general malaise, fever, weight loss, and anorexia. Topical retinoids are not as effective as oral retinoids. [statpearls.com]
Skin
- Skin Disease
PubMed On DermNet NZ Acne Acne conglobata SAPHO Facial acne images Other websites Acne fulminans – Medscape Drugs & Diseases Books about skin diseases Books about the skin Dermatology Made Easy book [dermnetnz.org]
His skin lesions were confined to the face; he did not present with fever; and he had no symptoms or signs indicating a systemic inflammatory disease such as inflammatory bowel disease or arthritis. [jamanetwork.com]
Patterson AT, Kaffenberger BH, Keller RA, et al; Skin diseases associated with Agent Orange and other organochlorine exposures. J Am Acad Dermatol. 2016 Jan74(1):143-70. doi: 10.1016/j.jaad.2015.05.006. Epub 2015 Jul 22. [patient.info]
Patients with HS-related arthritis may also experience other inflammatory skin diseases such as acne congloblata, dissecting cellulitis of the scalp and pilonidal sinus forming the follicular occlusion disorders as well as acne vulgaris and less commonly [biomeddermatol.biomedcentral.com]
- Dermatitis
The clinical description and course of acne conglobata place the disease in close relationship to dermatitis papillaris capillitii (Kaposi) and to perifolliculitis capitis abscedens et suffodiens (Hoffmann). [jamanetwork.com]
It was detected for the first time in 1903 by Splitzer in association with severe acne conglobata under the name of dermatitis follicularis et perifollicularis conglobata. In 1907, Hoffman described it as an isolated condition. [scielo.org.co]
Also, development of contact dermatitis to benzoyl peroxide is possible, and should be suspected in patients who develop marked erythema with its use. [dermatologyadvisor.com]
Musculoskeletal
- Arthritis
Tumor necrosis factor (TNF) inhibitors have become important components of the treatment of multiple chronic inflammatory disorders such as psoriasis, psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, Crohn [jamanetwork.com]
Previous cases of acne conglobata with arthritis reported in the literature were described as being cases of acne fulminans instead. We wish to point out that the first patient reported with acne conglobata and arthritis (2) was correctly diagnosed. [annals.org]
Pyogenic arthritis, pyoderma gangrenosum and acne syndrome maps to chromosome 15q. Am J Hum Genet 2000;66:1443-8. [ PUBMED ] [ FULLTEXT ] 4. Ehrenfeld M, Samra Y, Kaplinsky N. Acne conglobata and arthritis: Report of a case and review of literature. [ijdvl.com]
[…] gangrenosum, acne, suppurative hidradenitis), or PAPASH syndrome (pyogenic arthritis, pyoderma gangrenosum, acne, suppurative hidradenitis). [pubmed.ncbi.nlm.nih.gov]
Immunological studies of the arthritis of acne conglobata and hidradenitis suppurativa. Clin Exp Rheumatol. 1984 Oct-Dec. 2(4):309-11. [QxMD MEDLINE Link]. Ziff M, Maliakkal J. Acne conglobata and arthritis. Ann Intern Med. 1983 Mar. 98(3):417. [emedicine.medscape.com]
Psychiatrical
- Suicidal Ideation
Suicidal ideations are also common in this population. Thus, it is vital to offer them some mental health counseling. Evaluation The diagnosis is made clinically, and the discharge should be cultured. [statpearls.com]
Suicidal ideations are also common in this population. Thus, it is vital to offer them some mental health counseling. [ncbi.nlm.nih.gov]
Suicidal ideation, a concern in seemingly healthy adolescents, should be anticipated in those with cosmetically disturbing skin disorders, especially in adolescent males with acne conglobata. [40] It may be wise to order routine screening for psychological [emedicine.medscape.com]
Workup
Microbiology
- Staphylococcus Aureus
Staphylococcus epidermidis and Propionibacterium acnes are predominant in skin culture; Pseudomonas, Staphylococcus aureus and Streptococcus pyogenes are more rare 3. [bmrat.org]
Several serious side effects of isotretinoin therapy exist including acne fulminans, formation of excessive granulation tissue, and an increased risk of cutaneous infections (especially Staphylococcus aureus). [dermatologyadvisor.com]
Treatment
[…] with the situation prior to treatment. [pubmed.ncbi.nlm.nih.gov]
Additionally, antibiotic monotherapy either for acute treatment or maintenance therapy should be avoided. Systemic Treatments: Other Several other oral antibiotics have been used for the treatment of acne. [dermatologyadvisor.com]
Treatment Acne conglobata is challenging to treat. This type of acne absolutely must be treated by a dermatologist. Isotretinoin is by far the most common treatment and is generally the first treatment prescribed. [verywellhealth.com]
Facial Acne Conglobata Before and After Treatment With Adalimumab A, Study patient with severe facial nodular inflammatory acne. B, Clearance 3 months after initiation of treatment with adalimumab, 40 mg, twice monthly. [jamanetwork.com]
Treatment Isotretinoin (13-cis retinoic acid) is an oral pharmaceutical drug primarily preferred in the treatment of severe nodular acne. [intechopen.com]
Prognosis
Prognosis[28] The prognosis is good in patients treated appropriately and recurrence of acne fulminans is rare. Scarring and fibrosis may occur. [patient.info]
Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare Team [pubmed.ncbi.nlm.nih.gov]
The course of AC is chronic and the prognosis is poor. Squamous cell carcinoma has been reported to arise in chronic scars of AC. [9] Treatment is difficult and often ineffective. Intensive antibiotic therapy is necessary. [ijdvl.com]
Differential Diagnosis The differential diagnoses of acne conglobata include but are not limited to the following: Acne and suppurative hidradenitis (PASH) syndrome Acne fulminans Acne vulgaris Acneiform papulonodules Bromoderma Iododerma Rosacea fulminans Prognosis [ncbi.nlm.nih.gov]
Etiology
It is a systemic disease of unknown etiology characterized by necrotizing acne associated with constitutional symptoms and laboratory abnormalities. [nature.com]
Etiology It is believed that Propionibacterium acnes, the same organism implicated in acne vulgaris, may play an important role in the disease by changing its reactivity as an antigen. [ncbi.nlm.nih.gov]
This finding suggests that these clinically distinct disorders may share a genetic etiology. Etiology The primary cause of acne conglobata remains unknown. [emedicine.medscape.com]
Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare Team [pubmed.ncbi.nlm.nih.gov]
Epidemiology
Epidemiology of acne vulgaris. Br J Dermatol. 2013;168:474–85. Article CAS Google Scholar Braun-Falco M, Kovnerystyy O, Lohse P, Ruzicka T. [biomeddermatol.biomedcentral.com]
Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare Team [pubmed.ncbi.nlm.nih.gov]
Epidemiology It is a rare condition and becoming rarer, due to improved treatment of acne. The typical patient is a young male aged between 13 and 22[24]. [patient.info]
Epidemiology Acne conglobata is not very common. Overall, it is more common in men than women. [statpearls.com]
Pathophysiology
Abstract The pathophysiology and treatment of hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of the scalp, which constitute the follicular occlusion triad, are reviewed. [insights.ovid.com]
Furthermore, the pathophysiology of acne indicates the presence of inflammatory markers especially in severe nodulocystic acne rather than it simply being ‘blocked pores,’” says Saxon D. [dermatologytimes.com]
Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare Team [pubmed.ncbi.nlm.nih.gov]
Whether it occurs more frequently in any specific race is not known. [7] Pathophysiology Acne conglobata presents with deep burrowing abscesses that interconnect with each other via sinus tracts. [statpearls.com]
Whether it occurs more frequently in any specific race is not known.[7] Pathophysiology Acne conglobata presents with deep burrowing abscesses that interconnect with each other via sinus tracts. [ncbi.nlm.nih.gov]
Prevention
The recommended treatment is oral isotretinoin which should be commenced early to prevent scarring. Treatment is required for at least five months, and further courses are sometimes necessary. [dermnetnz.org]
The clinical effects of treatment options for acne conglobata are often unsatisfactory because of a long course of therapy, side effects, the high rate of recurrence, and failure to prevent scar formation. [intechopen.com]
Prevention[5] There is nothing that can be done to prevent this disease but it needs to be treated energetically to minimise the psychological impact and to reduce scarring. [patient.info]
As you see improvements, you’ll need to stick with your treatment plan to make sure your medications keep working to prevent new nodules from forming. Your dermatologist will see you at regular intervals to monitor your treatment. [healthline.com]