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Acne fulminans

Author: Reviewed and updated by Dr Amanda Oakley Dermatologist, Hamilton, New Zealand, Vanessa Ngan, Staff Writer, and Clare Morrison, Copy Editor, April 2014.

What is acne fulminans?

Acne fulminans is a rare and very severe form of acne conglobata associated with systemic symptoms. It nearly always affects adolescent males.

What are the clinical features of acne fulminans?

Acne fulminans is characterised by:

Tests typically reveal:

What causes acne fulminans?

Acne fulminans has been associated with increased androgens (male hormones), autoimmune complex disease and genetic predisposition. It may be related to an explosive hypersensitivity reaction to surface bacteria (Propionibacteria acnes). Acne fulminans may be precipitated by:

The syndrome SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) may be a serious complication of acne fulminans.

What is the treatment for acne fulminans?

Patients with acne fulminans should consult a dermatologist urgently. Management can prove difficult, and several medications are usually required for several months or longer. These may include:

Topical acne medications are unhelpful.

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