Acne fulminans: explosive systemic form of acne
ABSTRACT Acne fulminans (AF) is a rare severe form of acne vulgaris associated with systemic symptoms. It primarily affects male adolescents. Although the aetiology of AF remains unknown, many theories have been advanced to explain it. There have been reported associations with increased androgens, autoimmune complex disease and genetic pre-disposition. The disease is destructive, with the acute onset of painful, ulcerative nodules on the face, chest and back. The associated systemic manifestations such as fever, weight loss and musculoskeletal pain are usually present at the onset. The patients are febrile, with leucocytosis and an increased erythrocyte sedimentation rate. They may require several weeks of hospitalization. The treatment of AF has been challenging; the response to traditional acne therapies is poor. The recommended treatment is aggressive and consists of a combination of oral steroids and isotretinoin. To avoid the relapses, duration of such treatment should not be less than 3-5 months. Although the prognosis for patients treated appropriately is good, these acute inflammatory nodules often heal with residual scarring.
SourceAvailable from: sciencedirect.comJournal of the American Academy of Dermatology 02/2014; 70(2):e39-41. DOI:10.1016/j.jaad.2013.09.052 · 5.00 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: We explored the utility of poly(vinylalcohol) (PVA) film as a pharmaceutical transdermal carrier of erythromycin (EM) for the treatment of acne. EM-loaded PVA films were manufactured using PVA solution containing different amounts of EM in the presence or absence of various additives. Among the additives tested (glycerin, PEG, Tween80, CCT oil, and carboxymethylcellulose [CMC]), glycerin and PEG were suitable for the preparation of EMloaded PVA films. Several additives controlled the characteristic endothermic peaks of PVA and EM. Permeation of EM into the skin was measured using the prepared PVA films loaded with different EM concentrations and additives. EM from the EM-loaded PVA films showed sustained release behavior, and altering the amount of EM loaded and the additive allowed us to control the amount of EM released from these films. In conclusion, the PV films described here can serve as pharmaceutical transdermal carriers for sustained EM release.Fetal ovine model for in-situ esophagus tissue engineering 06/2014; 11(3):211. DOI:10.1007/s13770-014-0018-7 · 0.61 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Acne fulminans is a rare and serious condition characterized by the sudden onset of nodular and ulcerative acne lesions associated with systemic symptoms. It has been recognized a subset of patients with a sudden worsening of acne, often during treatment with oral isotretinoin, but without the strong presence of systemic involvement. Recognized by some authors as "pseudo-acne fulminans" or " acne fulminans sine fulminans," we report a case with these features in order to draw attention to the recognition and early management of this manifestation.Anais brasileiros de dermatologia 07/2014; 89(4):657-659. DOI:10.1590/abd1806-4841.20143024