An acneiform drug eruption is considered to be an important cutaneous drug-induced adverse effect. It has been described in patients taking both topical and systemic drugs [1], with the most involved classes being antimicrobials (tetracycline, streptomycin, isoniazid, clofazimine, and antimycotics), central nervous system (CNS)-acting agents (lithium, phenobarbital, and hydantoin derivatives such as phenytoin), chemotherapeutics (epidermal growth factor receptor - EGFR inhibitors such as cetuximab, erlotinib, and gefitinib, but also cyclosporin A), interferon (IFN), gold salts, etc. [1] [2] [3] [4]. Corticosteroids, in topical as well as systemic formulations, are particularly associated with an acneiform drug eruption in women [1]. The typical signs are characterized by the onset of skin lesions within several days after the introduction of drugs [5]. Erythematous follicular papules are the hallmark of an acneiform drug eruption [1] [3] [5] [6]. These lesions develop on the face, but also on the extremities, particularly on the forearms and buttocks, whereas the shoulders, the retroauricular area, and the superior portion of the trunk might serve as additional locations [1] [3] [5] [6]. The papules are further differentiated from acne vulgaris by the formation of punctiform vesicles in the center, followed by vesiculopustular progression [1]. Additional findings that exclude acne vulgaris are the absence of comedones that should normally precede the formation of acne, the older age of the patient (acne are primarily seen in adolescence), accompanying signs of systemic drug toxicity (eg. fever or malaise), and resolution of lesions after discontinuation of the drug [1] [5].

• Turkish

  MEMBERSHIPS Turkish Medical Association, Turkish Society of Dermatology. SCIENTIFIC PUBLICATIONS Approximately 25 publications in peer-reviewed international journals and many articles in national journals. [books.google.com]

• Muscle Spasticity

  Dantrolene sodium: long-term effects in patients with muscle spasticity. Arch Phys Med Rehabil. 1976;57:212–7. PubMed Google Scholar 98. Jones C, Bleehen SS. Acne induced by PUVA treatment. Br Med J. 1977;2:866. PubMed Google Scholar 99. [link.springer.com]

• Acneiform Eruption

  Diagnosis", publisher "Springer New York", } TY - CHAP T1 - Drug-Induced Acneiform Eruptions T2 - Drug-induced Acneiform Eruptions AU - Do, Ha K. [indiana.pure.elsevier.com]

  Follicular acneiform eruption induced by imatinib. J Eur Acad Dermatol Venereol. 2006;20:1368–70. PubMed Google Scholar 46. Lee JE, Lee SJ, Lee HJ, Lee JH, Lee KH. Severe acneiform eruption induced by cetuximab (Erbitux). [link.springer.com]

  Acneiform Eruptions in Dermatology is a practical, full-color guide to the differential diagnosis of acne vulgaris and the treatment of acne-like conditions. [books.google.com]

  Access personal reporting Related Content This Book Next chapter Acneiform Eruptions and Pregnancy By Aslı Feride Kaptanoglu and Didem Mullaaziz Related Book First chapter Introductory Chapter: An Introduction to Burn Injuries By Selda Pelin Kartal, Cemile [intechopen.com]

  The biopsy was compatible with an acneiform eruption. Acne vulgaris and acneiform eruptions. En su práctica reacciones adversas sospechadas reaccion adversa fecha. El Instituto Geografico Nacional de Guatemala implemento 17 Report. [voduhivodarage.tk]

• Acne Vulgaris

  The papules are further differentiated from acne vulgaris by the formation of punctiform vesicles in the center, followed by vesiculopustular progression. [symptoma.com]

  Acne vulgaris is a polymorphic infl ammatory skin disease, clinically characterized by mixture of comedones, superficial and deep infl amed papules, pustules, and nodules. It is a chronic infl ammation of the pilosebaceous unit. [indiana.pure.elsevier.com]

  Acneiform Eruptions in Dermatology is a practical, full-color guide to the differential diagnosis of acne vulgaris and the treatment of acne-like conditions. [books.google.com]

  Chapter First Online: 03 October 2013 Abstract Acne vulgaris is a polymorphic inflammatory skin disease, clinically characterized by mixture of comedones, superficial and deep inflamed papules, pustules, and nodules. [link.springer.com]

  The distribution of lesions was similar to that in acne vulgaris. Inflammatory papules were the predominant lesions [Table - 3] .. [ijdvl.com]

• Exanthema

  Warfarin can cause infarction Symmetrical drug related intertriginous and flexural exanthema (SDRIFE) - a symmetrical erythematous rash affecting the buttocks/natal cleft, peri-anal region or groins, usually along with one or more other flexural sites [pcds.org.uk]

  Acneiform exanthema caused by azathioprine. Hautarzt. 1983;34:413–5. PubMed Google Scholar 78. Hjortshoj A. Lichen planus and acne provoked by gold. Acta Derm Venereol. 1977;57:165–7. PubMed Google Scholar 79. Blatt J, Lee PA. [link.springer.com]

  Non-immediate without systemic involvement (6-10 days after first drug exposure or within three days of second exposure) - widespread red macules or papules (exanthema‑like) or fixed drug eruption. [patient.info]

• Follicular Plugging

  Follicular plugging, retention cyst and perivascular mononuclear infiltrate with extravasation of RBCs were seen in all the 4 biopsies of patients with INAH induced lesion (Fia. 2). [ijdvl.com]

• Pigmented Scar

  scars, etc., if proper treatment is not administered. [dovemed.com]

The diagnosis of an acneiform drug eruption rests on the ability of the physician to identify the key findings and establish the underlying cause. For this reason, a thorough patient history and a detailed physical examination are main steps in order to raise suspicion toward this entity. Recent administration of the previously mentioned pharmacological agents is perhaps the crucial piece of information that can be obtained. Other patient details, such as age, the presence of underlying disorders for which these drugs are used, and the pattern of rash distribution are equally important for making a presumptive diagnosis. Recognition of an acneiform drug eruption is mainly based on clinical grounds, but a biopsy with subsequent histopathological examination can be performed. Typical findings include spongiosis, disruption of the follicular epithelium and a nonspecific inflammatory reaction with both lymphocytes and neutrophils [5], whereas a suppurative follicular inflammation with a dense neutrophilic infiltrate is reported by other authors [6].

1. Rosa DJ, Matias FAT, Cedrim SD, Machado RF, Sá AA, Silva VC. Acute acneiform eruption induced by interferon beta-1b during treatment for multiple sclerosis. An Bras Dermatol. 2011;86:336–338.
2. Du-Thanh A, Kluger N, Bensalleh H, Guillot B.Drug-induced acneiform eruption. Am J Clin Dermatol. 2011;12(4):233-245
3. Pontello Junior R, Kondo RN. Drug-induced acne and rose pearl: similarities. An Bras Dermatol. 2013;88(6):1039-1040.
4. Plewig G, Jansen T. Acneiform dermatoses. Dermatology. 1998;196(1):102-107.
5. Segaert S, Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol. 2005;16:1425–1433.
6. Lee JE, Lee SJ, Lee HJ, Lee JH, Lee KH. Severe acneiform eruption induced by cetuximab (Erbitux) Yonsei Med J. 2008;49:851–852