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Acne fulminans in 14 years old male. A case report / Justina Maciulyte, Ieva Vaitkeviciute, Arunas Petkevicius, Giedre Trumpulyte, Jurgita Makstiene, Skaidra Valiukeviciene
Type of publication
Recenzuojamos išplėstinės tezės / Peer-reviewed extended theses (T1d)
Author(s)
Title
Acne fulminans in 14 years old male. A case report / Justina Maciulyte, Ieva Vaitkeviciute, Arunas Petkevicius, Giedre Trumpulyte, Jurgita Makstiene, Skaidra Valiukeviciene
Publisher (trusted)
Baltic Association of Dermatovenerologists (BADV) |
Date Issued
Date Issued |
---|
2021-09-17 |
Extent
p. 112-113.
Is part of
17th Congress of the Baltic Association of Dermatovenerologists (BADV) : 17-19 September 2021, Kaunas, Lithuania : online abstract book / Baltic Association of Dermatovenerologists ; [Editor Skaidra Valiukeviciene ; Abstracts' Reviewers: Ruta Ganceviciene, Jurate Grigaitiene, Vesta Kucinskiene]. Kaunas : BADV, 2021. ISBN 9786099616742.
Version
Originalus / Original
Description
no. PO 3–11
Poster Abstracts
ISBN 978-609-96167-4-2
Bibliogr.: p. 113
Field of Science
Abstract
Introduction Acne fulminans (AF) is the rarest and most severe form of acne. The disease usually affects adolescent males and manifests in painful ulcerated nodular lesions especially on the face, chest and back that results in severe scarring. Its treatment is usually very complex and challenging due to its resistance to various treatments. Until now there are less than 200 cases of AF reported. [1,2]. Aims and Objectives The aim is to present a severe acne fulminans case in association with panniculitis, fever, neutrophilic leukocytosis, anaemia. Materials and methods A 14-year-old male patient (body weight 50 kg) has a history of acne since 10 years old, and a positive family history of acne of his father. Initial treatment with isotretinoin 30 mg/d was started. During treatment the patient reported outcome according to VAS scale improved slightly (from 9 to 6 points). At the fourth month of isotretinoin use, a cellulitis like painful lesions on the patient's shins, and febrile fever appeared. The patient was admitted to the department of pediatric surgery for necrectomy of multiplex ulcerated nodules and symptomic systemic treatment with oxacillin 2g 4x/d and metronidazole per os for 6 days. During dermatological examination we found multiplex ulcerated nodules with hemorrhagic crusts, pustules, papules on the patients chest and back. On the shins - erythematous infiltrated painful subcutaneous plaques symmetrically. Results In laboratory tests: CRP – 88 mg/l, leukocytosis (13,7 x 10/9) with neutrophilia, anaemia (Hb –114 g/l) was found. Staphylococcus aureus was found in the culture of lesional skin. In shins ultrasound - subcutaneous adipose tissue infiltration zones, without local fluid accumulation was observed, which is characteristic of a panniculitis. Histological examination of rashes on shins, correspondingly pustules on trunk revealed abundant infiltration with neutrophils, lymphocytes and solitary granulocytes. Clinical diagnosis of acne
fulminans with panniculitis and systemic symptoms present (AF-SS) was made and it was decided to start oral corticosteroids 25- 40 mg/d, to decrease isotretinoin dose to 10 mg/d and to continue this treatment for up to 12 months until lesions heal over. Conclusions Acne fulminans is a very severe and complex disease that requires an intense treatment [2]. It is very important to diagnose and differentiate between AF, SAPHO syndrome and neutrophilic dermatoses such as Sweet syndrome.
Type of document
type::text::conference output::conference proceedings::conference paper
ISBN (of the container)
9786099616742
9786099616742
Other Identifier(s)
(LSMU ALMA)990001049160107106
Coverage Spatial
Lietuva / Lithuania (LT)
Language
Anglų / English (en)
Affiliation(s)