acne fulminans

Acne Fulminans

Acne Fulminans is a rare and particularly severe form of acne vulgaris. With only about 100 cases reported worldwide, acne fulminans appears almost exclusively in young men. The sudden onset of ulcerating acne lesions coupled with fever and multiple joint pain and swellings are hallmarks of this disfiguring condition.

Who Is At Risk of Acne Fulminans?

  1. Men aged 13-22 years of age with a history of acne
  2. Nodular acne
  3. Severe inflammatory acne on the chest, shoulders and back.
  4. High starting dose of oral isotretinoin 

Treatment of Acne Fulminans

An overdrive of the immune systems appears to be responsible for the abrupt onset and severity of the symptoms these individuals experience. Oral steroids that aid in immunosuppression are required in the treatment of acne fulminans. The additional anti-inflammatory effects of oral steroids help reduce fever, acne and joint pain and swelling. 

Oral antibiotics may be started concomitantly to treat any secondary infection. The use of oral isotretinoin is slowly introduced after 4 weeks of oral steroids to clear the severe acne skin lesions.

Other treatment options include Dapsone, Methotrexate, Ciclosporin and biological therapy using Infliximab.

Complications of Acne Fulminans

  • Severe Scarring
  • Keloid Scars
  • Bone destruction (clavicle, sternum, long bones)

Further Information:

  1. Acne Fulminans – Dermnet New Zealand
  2. Acne Fulminans – Emedicine