Arora Sandeep, Malik Ajay, Kumar Dharmendra, Sodhi Neha
Department of Dermatology, Army College of Medical Sciences, Base Hospital, Delhi, India.
Department of Pathology, Army College of Medical Sciences, Base Hospital, Delhi, India.
Indian Dermatol Online J. 2016 Mar-Apr;7(2):93-5. doi: 10.4103/2229-5178.178080.
Acne fulminans (AF) is a very rare severe form of acne seen in young males, characterized by a sudden and explosive onset of hemorrhagic pustules and ulceration on the trunk, systemic features in the form of fever, polyarthropathy, malaise, erythema nodosum and painful osteolytic bone involvement with leukocytosis, and an elevated erythrocyte sedimentation rate. Conventional treatment of AF includes corticosteroids or immunosuppressive agents for the initial phase followed by isotretinoin. Active hepatitis B infection with a high viral load precludes the administration of any immunosuppressive drugs. We present the case of an 18-year-old girl with a history of occasional acne who presented with AF of sudden onset following administration of interferon-alpha-2a for her recently detected hepatitis B infection. Management of hepatitis B was withheld in view of her general condition. The patient was managed with low dose isotretinoin with subsidence of lesions. AF in a young female precipitated by interferon and its management with isotretinoin in the presence of active hepatitis B infection make the case unique.
暴发性痤疮（AF）是一种在年轻男性中罕见的严重痤疮形式，其特征为躯干突然出现出血性脓疱和溃疡，伴有发热、多关节病、不适、结节性红斑等全身症状，以及疼痛性溶骨性骨受累并伴有白细胞增多和红细胞沉降率升高。AF的传统治疗包括在初始阶段使用皮质类固醇或免疫抑制剂，随后使用异维A酸。高病毒载量的活动性乙型肝炎感染排除了使用任何免疫抑制药物的可能性。我们报告一例18岁女孩的病例，该女孩有偶尔患痤疮的病史，在因最近检测出的乙型肝炎感染而接受α-2a干扰素治疗后突然发生AF。鉴于其总体状况，暂未对乙型肝炎进行治疗。该患者采用低剂量异维A酸治疗，皮损消退。由干扰素诱发的年轻女性AF以及在活动性乙型肝炎感染情况下用异维A酸进行治疗，使该病例具有独特性。
