Edit concept Question Editor Create issue ticket

Acne Conglobata


Presentation

  • Enhancing Healthcare Team Outcomes Patients with acne usually present to their primary care provider or nurse practitioner.[statpearls.com]
  • Painful splenomegaly, inflammatory arthralgia (this especially affects the hips and knees), bone pain, erythema nodosum and chronic aseptic multifocal osteomyelitis may be present.[patient.info]
  • The unusual occurrence of all three components in a single patient resistant to medical management is presented with a review of the literature.[insights.ovid.com]
  • However, durability of remission is unknown, and therefore the present evidence does not support a curative role of TNF inhibitors in acne.[jamanetwork.com]
  • At present, this condition is defined as a primary disorder of follicular keratinization, being part of the triad or tetrad of follicular occlusion. One third of the cases are associated with acne conglobata as a primary event.[scielo.org.co]
Weight Gain
Anorexia
  • 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]
Loss of Hair
  • This test consists of taking approximately 60 strands of hair and pulling them from the proximal to the distal part, if six or more hairs are detached this indicates the test is positive and there is an active loss of hair.[scielo.org.co]
Aspiration
  • Surgical Care Large hemorrhagic nodules may be aspirated. Intralesional triamcinolone or cryotherapy may also be valuable. Occasionally, surgical excision of interconnecting large nodules may be beneficial.[tibot.ai]
  • Modern external beam radiation has been used with some success. [ 15 ] Infliximab has been tried but not with good results. [ 16 ] However, one study reported the successful use of adalimumab. [ 17 ] Surgery [ 18 ] Large haemorrhagic nodules may be aspirated[patient.info]
  • When nodules are large and fluctuant, they can be aspirated. Sometimes practitioners may use cryotherapy or intralesional triamcinolone. The large nodules can also be excised surgically.[statpearls.com]
Widely Spaced Teeth
  • Dermatological examination revealed cutis verticis gyrata, thick eyelids, a large triangular nose, a thickened lower lip, macroglossia, widely spaced teeth and widened skin pores with wet and oily skin. Hair was fine and nails were flat and wide.[ijdvl.com]
Photosensitivity
  • Use of sunscreen in patients on medications that can cause photosensitivity, such as retinoids or doxycycline, is a must and their use should be advocated with each visit.[dermatologyadvisor.com]
Darkly Pigmented Skin
  • The risks of corticosteroid injections include hypopigmentation (particularly in darkly pigmented skin), atrophy, telangiectasias and needle tract scarring.[dermatologyadvisor.com]
Decreased Sweating
  • Long-term side effects include dry skin, decreased sweating, skin color changes, loss of scalp hair, and the development of dilated blood vessels [ 24 ].[intechopen.com]
Self-Inflicted Wound
  • Acne excoriée: mainly affects young women and is characterised by self-inflicted wounds associated with a psychological or emotional problem. Acne mechanica… CONTINUE READING References Publications referenced by this paper.[semanticscholar.org]
  • Acne excoriée: mainly affects young women and is characterised by self-inflicted wounds associated with a psychological or emotional problem.[patient.info]
Increased Libido
  • Some patients noted health benefits beyond improved in acne such as decreased facial oiliness, decreased hirsutism, improvement of premenstrual syndrome symptoms, decreased metrorrhagia, reduced endometriosis pain, and increased libido.[dermatologyadvisor.com]
Facial Scar
  • Many young adult males will present to the dermatology clinic complaining of severe acne and facial scars. It is important to seek a thorough history of use of anabolic steroids because discontinuation of these agents is vital for treatment.[statpearls.com]
Excitement
  • Absorption of light excites the porphyrin compound, causing formation of reactive free radicals, which damage lipids in the cell wall of P. acnes, resulting in destruction of the organism.[dermatologyadvisor.com]
Metrorrhagia
  • Some patients noted health benefits beyond improved in acne such as decreased facial oiliness, decreased hirsutism, improvement of premenstrual syndrome symptoms, decreased metrorrhagia, reduced endometriosis pain, and increased libido.[dermatologyadvisor.com]

Treatment

  • 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]
  • 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]
  • Several studies indicated topical 5-aminolevulinic acid photodynamic therapy (ALA-PDT) improved follicular occlusion besides acne treatment. So we attempted to apply ALA-PDT to medicine resistant AC, PCAS and HS.[worldscientific.com]
  • Topical treatments Topical treatments alone won’t work for Acne conglobata. However, they may be used along with oral medications for better results.[tibot.ai]

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]
  • Prognosis Acne conglobata can produce pronounced disfigurement. Severe scarring produces psychological impairment; individuals with acne conglobata are often ostracized, or they may feel excluded.[emedicine.medscape.com]

Etiology

  • 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]
  • 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.[statpearls.com]
  • It is a systemic disease of unknown etiology characterized by necrotizing acne associated with constitutional symptoms and laboratory abnormalities.[nature.com]
  • Another theory is that AFs could be associated with an autoimmune etiology and genetic factors 3 4 6. Normally, blood culture tests of AF patients are negative.[bmrat.org]

Epidemiology

  • Epidemiology It is a rare condition and becoming rarer, due to improved treatment of acne.[patient.info]
  • Epidemiology Acne conglobata is not very common. Overall, it is more common in men than women.[statpearls.com]
  • Acne conglobata and acne fulminans may appear after cessation of testosterone therapy or as a reaction to other medications. [9] Epidemiology Frequency Acne conglobata is an uncommon disease.[emedicine.medscape.com]
Sex distribution
Age distribution

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]
  • 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]
  • Pathophysiology The primary causes of acne conglobata remain unknown. Chromosomal defects in the XYY karyotype may be responsible for severe forms of acne conglobata.[emedicine.medscape.com]

Prevention

  • 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]
  • 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]
  • 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]
  • Additionally, as they do not affect the formation of both comedones and the microcomedo, therapy needs to be combined with retinoids to prevent future acne. However, it may be a good adjuvant therapy for some patients.[dermatologyadvisor.com]
  • Author Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public[emedicine.medscape.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!