Sotoodian Bahman, Kuzel Paul, Brassard Alain, Fiorillo Loretta
Department of Medicine, Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Canada.
Department of Pediatrics, Department of Medicine, Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Canada.
Cutis. 2017 Dec;100(6):E23-E26.
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.
暴发性痤疮是一种罕见且使人虚弱的疾病，表现为结节性和溃疡性痤疮皮损的急性发作并伴有全身症状。它常见于年轻青春期男性患者使用异维A酸治疗重度痤疮（如聚合性痤疮）期间。异维A酸和多西环素也可能在患有重度痤疮皮损的患者中诱发嗜中性皮病，其特征为疼痛性溃疡性丘疹结节急性出现并伴有包括发热和白细胞增多在内的全身症状。我们报告了一例具有挑战性的病例，一名13岁青少年男性在接受多西环素和异维A酸治疗聚合性痤疮后急性出现数百个溃疡性斑块以及全身症状。他接受了泼尼松、氨苯砜和秋水仙碱治疗，并且不得不改用环孢素以缓解病情。
