Tan B B, Lear J T, Smith A G
Department of Dermatology, Central Outpatients, Stoke-on-Trent, UK.
Clin Exp Dermatol. 1997 Jan;22(1):26-7. doi: 10.1046/j.1365-2230.1997.1830600.x.
Acne vulgaris is very common, 85% of teenagers being affected at any one time. In most cases, the disease is mild and patients do not present to the dermatologist. Most are instead treated with over-the-counter products and conventional treatment such as peeling agents or topical and systemic antibiotics. Isotretinoin has revolutionized the treatment of severe acne unresponsive to oral antibiotics. Explosive and very severe acne such as pyoderma faciale, acne conglobata and acne fulminans are rare, the features that distinguish acne fulminans from the other conditions being systemic upset with fever, joint pain, malaise and leucocytosis, while there have been two reports of the condition associated with erythema nodosum. The recommended treatment for acne fulminans is a combination of oral steroids and systemic antibiotics, isotretinoin probably not being the treatment of choice. We now report a patient who developed acne fulminans and erythema nodosum within 3 weeks of starting isotretinoin and then responded to dapsone without oral steroids.
寻常痤疮非常常见，任何时候都有85%的青少年受其影响。在大多数情况下，该病症状较轻，患者不会去看皮肤科医生。大多数患者转而使用非处方产品以及传统治疗方法，如剥脱剂或局部及全身用抗生素。异维A酸彻底改变了对口服抗生素无反应的重度痤疮的治疗方法。暴发性和非常严重的痤疮，如面部脓皮病、聚合性痤疮和暴发性痤疮很罕见，暴发性痤疮与其他病症的区别特征是伴有发热、关节疼痛、不适和白细胞增多的全身不适，同时有两例该病症与结节性红斑相关的报道。暴发性痤疮的推荐治疗方法是口服类固醇和全身用抗生素联合使用，异维A酸可能不是首选治疗方法。我们现在报告一名患者，该患者在开始服用异维A酸3周内出现了暴发性痤疮和结节性红斑，随后对氨苯砜有反应，未使用口服类固醇。
