Acne Fulminans
Author: Victoria Young MS2, Y, Miller-Monthrope, Dermatologist/Dermatopathologist, Toronto, Canada, 2024
Definition: Acne fulminans (AF) is a rare, severe variant of inflammatory acne characterized by the sudden onset of painful ulcerated or eroded acne lesions with hemorrhagic crusts that can lead to scars.
Symptoms: AF is often accompanied by systemic symptoms such as fever, arthralgias and joint pain and malaise.
Etiology: Increased androgens, a hypersensitivity reaction to C. acnes, genetic predisposition and even isotretinoin have all been implicated in the etiology of AF.
Epidemiology: AF primarily affects adolescent males, with a history of acne vulgaris. It typically between the ages of 13 and 22. It has been reported more commonly in white patients however it may occur in all skin tones.
Diagnosis: Laboratory findings may show elevated inflammatory markers and leukocytosis. Treatment: Treatment of AF typically involves systemic corticosteroids in the immediate onset to control inflammation, often followed by isotretinoin.
References:
1. Dall’oglio F, Puglisi DF, Nasca MR & Micali G (2020). Acne fulminans.. Giornale Italiano di Dermatologia e Venereologia, 155(6), 711-718. https://dx.doi.org/10.23736/S0392-0488.20.06711-5
2. Greywal T, Zaenglein AL, Baldwin HE, Bhatia N, Chernoff KA, Del Rosso JQ, Friedlander SF (2017). Evidence-based recommendations for the management of acne fulminans and its variants.. Journal of the American Academy of Dermatology, 77(1), 109-117. https://dx.doi.org/10.1016/j.jaad.2016.11.028
3. Oakley A et al. Acne Fulminans | DermNet NZ. dermnetnz.org. Published April 2014.