1
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Nasseh J, Brun A, Theret V, Ramspacher J, Severino-Freire M, Coustou D, Bulai Livideanu C, Tauber M, Marguery MC, Paul C. Efficacy of tumor necrosis factor-alpha inhibitors in the treatment of isotretinoin-induced acne fulminans. J Eur Acad Dermatol Venereol 2024; 38:e96-e98. [PMID: 37595985 DOI: 10.1111/jdv.19446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023]
Affiliation(s)
- J Nasseh
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - A Brun
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - V Theret
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - J Ramspacher
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - M Severino-Freire
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - D Coustou
- Clinique Capio La Croix du Sud Ringgold standard institution - Dermatologie Quint-Fonsegrives, Occitanie, France
| | - C Bulai Livideanu
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - M Tauber
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - M C Marguery
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - C Paul
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
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2
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Yen H, Lalor L. Non-syndromic and Syndromic Severe Acne in Adolescent Patients. Med Clin North Am 2024; 108:27-42. [PMID: 37951654 DOI: 10.1016/j.mcna.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Acne is a common skin disorder in adolescents. However, severe acne that is persistent and refractory to conventional treatment or has other associated symptoms should raise suspicion for non-syndromic or syndromic acne.
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Affiliation(s)
- Hsi Yen
- Department of Dermatology, Division of Pediatric Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, TBRC 2nd Floor Suite C2010, Milwaukee, WI 53226, USA
| | - Leah Lalor
- Department of Dermatology, Division of Pediatric Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, TBRC 2nd Floor Suite C2010, Milwaukee, WI 53226, USA.
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3
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Ding RL, Zheng Y, Bu J. Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review. Clin Cosmet Investig Dermatol 2023; 16:1843-1854. [PMID: 37483471 PMCID: PMC10362870 DOI: 10.2147/ccid.s416267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023]
Abstract
Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.
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Affiliation(s)
- Rui-Lian Ding
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
| | - Yu Zheng
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
| | - Jin Bu
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
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4
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Gorai S, Banerjee P, Das K, Lahiri K. Hyponatremia and hypokalemia in acne fulminans, first correspondence of its kind. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_147_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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5
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Picone V, Potestio L, Fabbrocini G, Monfrecola G, Marasca C. A case of acne fulminans successfully treated with photodynamic therapy. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:401-403. [PMID: 34919759 DOI: 10.1111/phpp.12761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/15/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Vincenzo Picone
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Giuseppe Monfrecola
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
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6
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Truncal Acne: An Overview. J Clin Med 2022; 11:jcm11133660. [PMID: 35806952 PMCID: PMC9267677 DOI: 10.3390/jcm11133660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023] Open
Abstract
Acne is a relatively common disease of the pilosebaceous units. Many aspects of facial acne have been studied. However, there is limited evidence regarding truncal acne. Truncal acne is also observed in a significant number of patients, but it is often ignored by patients and clinicians. Although the pathogenesis of facial and trunk acne is considered to be similar, the characteristics of the skin on the trunk and face are thought to be different. As truncal acne can cause scars on large areas of the body and adversely affect the quality of life of patients, more attention should be given to patients with truncal acne. Although only a few studies have been published to date, the epidemiology, etiology, severity assessment tool, assessments of the quality of life, and new treatments targeting truncal acne are currently being studied. Therefore, in this review, the latest knowledge on truncal acne will be discussed.
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7
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Sánchez-Velázquez A, Falkenhain-López D, Arroyo-Andrés J, Montero-Menárguez J, García-Donoso C, Postigo-Llorente C. Apremilast: a novel adjuvant treatment for refractory isotretinoin-induced acne fulminans. Dermatol Ther 2022; 35:e15637. [PMID: 35703093 DOI: 10.1111/dth.15637] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/14/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Alba Sánchez-Velázquez
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Daniel Falkenhain-López
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Jorge Arroyo-Andrés
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Julia Montero-Menárguez
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Carmen García-Donoso
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Concepción Postigo-Llorente
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
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8
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The Immunogenetics of Acne. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:137-154. [DOI: 10.1007/978-3-030-92616-8_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Marasca C, Fabbrocini G, Abategiovanni L, Camela E, Nocerino M, Di Guida A, De Fata Salvatores G. Adalimumab in the Management of Isotretinoin-Induced Acne Fulminans: Report of a Case. Skin Appendage Disord 2021; 7:115-119. [PMID: 33796557 DOI: 10.1159/000512032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/05/2020] [Indexed: 01/26/2023] Open
Abstract
Acne fulminans (AF) is a rare, acute, and severe form of acne vulgaris often associated with systemic symptoms. Its treatment is challenging and controversial. We report a case of isotretinoin-induced AF (IIAF) in a 12-year-old boy resistant to traditional therapies (oral steroids and isotretinoin). The patient was successfully treated with adalimumab that can be considered an effective off-label option in the treatment of resistant IIAF in children.
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Affiliation(s)
- Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luisa Abategiovanni
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Adriana Di Guida
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gaia De Fata Salvatores
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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10
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Furukawa F, Makino T, Mori S, Shimizu T. Successful treatment of acne fulminans with the combination of prednisolone and diaminodiphenylsulfone. J Dermatol 2020; 48:e120-e121. [PMID: 33222301 DOI: 10.1111/1346-8138.15699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Fumina Furukawa
- Department of Dermatology, Graduate school of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Teruhiko Makino
- Department of Dermatology, Graduate school of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shuichi Mori
- Department of Dermatology, Graduate school of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Tadamichi Shimizu
- Department of Dermatology, Graduate school of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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11
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Xu X, Li X, Pradhan S, Li W. Acne fulminans concomitant with vasculitis-like symptoms mimicking Henoch-Schoenlein purpura. Pediatr Dermatol 2020; 37:1169-1170. [PMID: 33006150 DOI: 10.1111/pde.14373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Acne fulminans is a severe form of acne vulgaris accompanied by systemic symptoms. A 17-year-old Chinese boy presented with an outbreak of necrotic lesions on his face eight days after the onset of palpable purpura, arthralgia, fever, abdominal pain, and proteinuria. He was successfully treated with oral prednisolone and isotretinoin. Vasculitis-like symptoms are rarely reported in acne fulminans; therefore, the physician needs to maintain awareness of this uncommon presentation.
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Affiliation(s)
- Xiaoxi Xu
- Department of Dermatovenereology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohua Li
- Department of Dermatovenereology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
| | - Sushmita Pradhan
- Department of Dermatovenereology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Li
- Department of Dermatovenereology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
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12
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Abstract
Acne fulminans (AF) is a rare and severe form of inflammatory acne presenting clinically with an abrupt outburst of painful, hemorrhagic pustules and ulceration, that may or may not be associated with systemic symptoms, such as fever, polyarthritis, and laboratory abnormalities. It typically affects male teenagers with a pre-existing acne. Although the pathogenetic mechanism has not been established yet, a role of genetic, abnormal immunologic response, drugs intake, hormonal imbalance and viral infection, as causal factors, has been identified. AF may occur as a single disease or may be associated with other disorders. Traditionally, AF has been classified, on the basis of the presence of systemic involvement, in "acne fulminans" and acne fulminans "sine fulminans," when no systemic involvement is present. Recently, four clinical variants have been proposed: acne fulminans with systemic symptoms (AF-SS), acne fulminans without systemic symptoms (AF-WOSS), isotretinoin-induced acne fulminans with systemic symptoms (IIAF-SS), isotretinoin-induced acne fulminans without systemic symptoms (IIAF-WOSS). The diagnosis of AF is usually based on clinical history and physical examination. No specific laboratory abnormalities are generally found. In selected cases, biopsy and/or radiologic imaging are helpful for a correct diagnosis. The treatment significantly differs from severe acne according to severity of clinical presentation and possible systemic involvement. Currently, systemic corticosteroids (prednisolone) and retinoids (isotretinoin) represent the first choice of treatment. Dapsone, cyclosporine A, methotrexate, azathioprine, levamisole, and biological agents such as anakinra, infliximab, adalimumab may be considered as alternative therapies in selected cases. Adjunctive topical and physical therapies may also be considered.
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Affiliation(s)
| | | | - Maria R Nasca
- Dermatology Clinic, University of Catania, Catania, Italy
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13
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Acne in the first three decades of life: An update of a disorder with profound implications for all decades of life. Dis Mon 2020; 67:101103. [PMID: 33041056 DOI: 10.1016/j.disamonth.2020.101103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular. Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne.
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Forouzani-Haghighi B, Karimzadeh I. Isotretinoin and the Kidney: Opportunities and Threats. Clin Cosmet Investig Dermatol 2020; 13:485-494. [PMID: 32801824 PMCID: PMC7395703 DOI: 10.2147/ccid.s259048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/08/2020] [Indexed: 11/26/2022]
Abstract
Retinoids are one of the most effective drugs in inducing complete or prolonged remission of severe acne vulgaris, but the adverse reactions associated with the use of them are raising a concern about the potential effect of these drugs on internal organs function such as the kidney. The aim of this review is to comprehensively gather data about isotretinoin, both potential adverse and beneficial effects on the kidney based on the current experimental and clinical findings. Very few studies, including five case reports, described that systemic oral isotretinoin within usual doses (40 mg/day or 0.5 mg/kg⁄day) within 1 to 4 months of treatment might be associated with different types of renal dysfunctions. These include acute interstitial nephritis, nephrotic syndrome, and hematuria with dysuria. The adverse reactions of systemic isotretinoin on the kidney and urinary system are unlikely and rare. In contrast, six experimental studies demonstrated the beneficial effects of either oral or parenteral low- (2 or 5 mg/kg/day) or high- (10, 20, 25, 40 mg/kg/day) dose isotretinoin on the kidney in the rat models of glomerulonephritis, obstructive nephropathy or allograft nephropathy. The nephroprotective functions of isotretinoin in these studies were attributed to its anti-proliferative, anti-fibrotic, and anti-inflammatory actions. However, clinical studies are warranted to elucidate the possible beneficial effects of isotretinoin in preventing or attenuating kidney injury in different settings.
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Affiliation(s)
- Bahareh Forouzani-Haghighi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Karimzadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Meinzer U, See H, Bader-Meunier B, Juillard C, Duquesne A, Melki I, Faye A, Bourrat E. Clinical Characteristics of Acne Fulminans Associated With Chronic Nonbacterial Osteomyelitis in Pediatric Patients. J Rheumatol 2020; 47:1793-1799. [PMID: 32238518 DOI: 10.3899/jrheum.191232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Acne fulminans (AF) is a rare, explosive systemic form of acne. Chronic nonbacterial osteomyelitis (CNO) or chronic recurrent multifocal osteomyelitis (CRMO) is a primarily pediatric autoinflammatory disorder characterized by sterile osteolytic bone lesions. Concomitant occurrence of CNO/CRMO and AF is very rare, and little is known about the epidemiological and clinical particularities of this association. The aim of this retrospective observational study was to describe the characteristics of pediatric patients with CNO/CRMO associated to AF. METHODS Electronic mailing lists of French medical societies were used to call for patients with CNO/CRMO and AF. A search for published patients with CNO/CRMO and AF was performed by screening PubMed. RESULTS We identified 5 original patients and 10 patients from the literature. All patients were adolescent boys. Mean age at disease onset was 14.8 years. Nine of 15 patients had received isotretinoin before the sudden onset of AF. Osteoarticular symptoms appeared within < 1-3 months after the onset of AF. The mean numbers of clinical and radiological bone lesions were 3.6 and 5.6, respectively. The percentages of patients with involvement of vertebrae, pelvis, chest, and cranial were 40%, 40%, 33.3%, and 6.6%, respectively. Arthritis was observed in 69.2% of patients and sacroiliac arthritis in 46.2%. CONCLUSION CNO/CRMO associated to AF occurs predominantly in male adolescents and is characterized by frequent involvement of the axial skeleton and arthritis. Epidemiological and clinical features of these patients differ from general CNO/CRMO cohorts. Clinical management requires careful handling of isotretinoin doses.
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Affiliation(s)
- Ulrich Meinzer
- U. Meinzer, MD, PhD, Department of General Pediatrics, Pediatric Infectious Diseases and Pediatric Rheumatology, Hôpital Robert Debré, AP-HP, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Auto-immune diseases (RAISE), and Université Paris Diderot-Sorbonne Paris-Cité, INSERM, UMR1149, and Biology and Genetics of Bacterial Cell Wall Unit, Institut Pasteur, Paris;
| | - Helene See
- H. See, MD, I. Melki, MD, PhD, Department of General Pediatrics, Pediatric Infectious Diseases and Pediatric Rheumatology, Hôpital Robert Debré, Assistance Publique Hôpitaux de Paris AP-HP, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Auto-immune diseases (RAISE), Paris
| | - Brigitte Bader-Meunier
- B. Bader-Meunier, MD, Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Auto-immune diseases (RAISE), Paris
| | - Caroline Juillard
- C. Juillard, MD, Department of Dermatology, Hôpital Saint-Louis, Paris
| | - Agnes Duquesne
- A. Duquesne, MD, Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Auto-immune diseases (RAISE), Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon
| | - Isabelle Melki
- H. See, MD, I. Melki, MD, PhD, Department of General Pediatrics, Pediatric Infectious Diseases and Pediatric Rheumatology, Hôpital Robert Debré, Assistance Publique Hôpitaux de Paris AP-HP, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Auto-immune diseases (RAISE), Paris
| | - Albert Faye
- A. Faye, MD, PhD, Department of General Pediatrics, Pediatric Infectious Diseases and Pediatric Rheumatology, Hôpital Robert Debré, AP-HP, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Auto-immune diseases (RAISE), and Biology and Genetics of Bacterial Cell Wall Unit, Institut Pasteur, Paris
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16
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Bocquet-Trémoureux S, Corvec S, Khammari A, Dagnelie MA, Boisrobert A, Dreno B. Acne fulminans and Cutibacterium acnes phylotypes. J Eur Acad Dermatol Venereol 2020; 34:827-833. [PMID: 31715640 DOI: 10.1111/jdv.16064] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Acne fulminans (AF) is a rare and severe form of inflammatory acne. It is characterized by a sudden worsening of acne with appearance of ulceronecrotic lesions, which can be associated with systemic signs. Its pathophysiology and the best therapeutic strategy are only partially known. OBJECTIVE Our main objectives were to describe the clinical and biological profile of AF patients and to determine whether there was a difference in Cutibacterium acnes phylotype in AF compared to acne vulgaris. The secondary objective was to assess the efficacy of different therapies. METHODS A retrospective observational study was conducted in all patients followed for AF in our department between 2008 and 2018. Bacteriological samples were taken from each patient to analyse C. acnes phylotype distribution. The therapeutic response was assessed using the ECLA and GEA scales. RESULTS Fifteen patients with a median age of 15 years were included (12 men, 80%). A family history of acne was found in 86.7% of patients. Nine patients (60%) had isotretinoin-induced AF. Only one patient (6.7%) showed systemic signs. The bacteriological culture was positive for C. acnes in 80% of patients. The predominant phylotype was IA1 in 60% of patients, corresponding to the predominant phylotype in acne vulgaris. Only 33.3% of patients were in remission after a first-line treatment with systemic corticosteroids, alone or in combination. Seven patients were treated with biotherapy, including five successfully with secukinumab. CONCLUSION Our results suggest that there is no specific C. acnes phylotype associated with AF, raising the hypothesis that acute inflammation associated with AF may be more related to an abnormal cutaneous innate immunity activation. The use of preventive strategies, the impact of combined treatments and an assessment of the role of biotherapies, especially anti-IL-17, in AF treatment remain to be more investigated.
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Affiliation(s)
| | - S Corvec
- CIC 1413, CRCINA Inserm U 1232, University Nantes, Nantes, France.,Department of Bacteriology, CHU Nantes, Nantes, France
| | - A Khammari
- Department of Dermatology, CHU Nantes, Nantes, France.,CIC 1413, CRCINA Inserm U 1232, University Nantes, Nantes, France
| | - M-A Dagnelie
- CIC 1413, CRCINA Inserm U 1232, University Nantes, Nantes, France
| | - A Boisrobert
- Department of Dermatology, CHU Nantes, Nantes, France
| | - B Dreno
- Department of Dermatology, CHU Nantes, Nantes, France.,CIC 1413, CRCINA Inserm U 1232, University Nantes, Nantes, France
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17
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Sacroiliitis during isotretinoin treatment: Causal association or coincidence? North Clin Istanb 2019; 6:75-80. [PMID: 31180372 PMCID: PMC6526982 DOI: 10.14744/nci.2018.93798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 02/07/2018] [Indexed: 11/20/2022] Open
Abstract
Isotretinoin, a retinoid derivate used in acne treatment, has a variety of side effects involving the musculoskeletal system; however, sacroiliitis is rarely observed. Our aim was to present nine cases of sacroiliitis in patients being treated with isotretinoin. Sacroiliitis was identified and monitored using magnetic resonance imaging (MRI). Clinical symptoms were resolved with nonsteroidal anti-inflammatory drug therapy after isotretinoin treatment was ceased. Different from the other cases, follow-up MRI was done. Follow-up MRI revealed improvement in some patients. Although the association between isotretinoin therapy and sacroiliitis has been covered in literature, this association is not yet completely understood. We aimed to discuss the relationship between two.
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18
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Duchatelet S, Join-Lambert O, Delage M, Miskinyte S, Guet-Revillet H, Lam T, Coignard-Biehler H, Ungeheuer MN, Chatenoud L, Lortholary O, Nassif X, Hovnanian A, Nassif AS. Remission of chronic acne fulminans and severe hidradenitis suppurativa with targeted antibiotherapy. JAAD Case Rep 2019; 5:525-528. [PMID: 31205996 PMCID: PMC6558272 DOI: 10.1016/j.jdcr.2019.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sabine Duchatelet
- Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France.,University Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Olivier Join-Lambert
- Laboratoire de Microbiologie, Hôpital Necker Enfants Malades, Paris, France.,Physiopathologie des Infections Systémiques, Institut Necker-Enfants Malades, Paris, France.,CHU de Caen, Laboratoire de Microbiologie, Caen, France.,Groupe de Recherche sur l'Adaptation Microbienne, Caen, France.,Normandy University, Normandy, France
| | - Maïa Delage
- Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Snaigune Miskinyte
- Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France.,University Paris Descartes - Sorbonne Paris Cité, Paris, France
| | - Hélène Guet-Revillet
- Laboratoire de Microbiologie, Hôpital Necker Enfants Malades, Paris, France.,Physiopathologie des Infections Systémiques, Institut Necker-Enfants Malades, Paris, France
| | - Thi Lam
- Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Hélène Coignard-Biehler
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker Enfants Malades, Paris, France
| | | | - Lucienne Chatenoud
- Laboratoire d'immunologie, Hôpital Necker Enfants Malades, Paris, France
| | - Olivier Lortholary
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker Enfants Malades, Paris, France
| | - Xavier Nassif
- Laboratoire de Microbiologie, Hôpital Necker Enfants Malades, Paris, France.,Physiopathologie des Infections Systémiques, Institut Necker-Enfants Malades, Paris, France
| | - Alain Hovnanian
- Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France.,University Paris Descartes - Sorbonne Paris Cité, Paris, France.,Department of Genetics, Hôpital Necker Enfants Malades, Paris, France
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19
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Didona D, Paolino G, Cantisani C, Viti G, Caposiena Caro DR, Didona B. Acne fulminans following isotretinoin therapy. GIORN ITAL DERMAT V 2019; 154:84-85. [DOI: 10.23736/s0392-0488.17.05593-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Dawoud NM, Elnady BM, Elkhouly T, Yosef A. Adalimumab as a successful treatment for acne fulminans and bilateral acute sacroiliitis with hip synovitis complicating isotretinoin therapy. Indian J Dermatol Venereol Leprol 2018; 84:104-107. [PMID: 29284764 DOI: 10.4103/ijdvl.ijdvl_834_16] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Noha Mohammed Dawoud
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufia University, Shebin El Kom, Menoufia, Egypt; Department of Dermatology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Basant Mohammed Elnady
- Department of Physical Medicine and Rheumatology, Benha University, Banha, Egypt; Department of Rheumatology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Tohamy Elkhouly
- Department of Radiology, Benha University, Banha, Egypt; Department of Radiology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Ayman Yosef
- Department of Dermatology, Zagazig University, Zagazig, Egypt
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21
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Gualtieri B, Panduri S, Chiricozzi A, Romanelli M. Isotretinoin-triggered acne fulminans: a rare, disabling occurrence. GIORN ITAL DERMAT V 2018; 155:361-362. [PMID: 30229637 DOI: 10.23736/s0392-0488.18.06013-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bruno Gualtieri
- Department of Dermatology, "Santi Giovanni e Paolo" Hospital, Venice, Italy -
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22
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Walsh RK, Endicott AA, Shinkai K. Diagnosis and Treatment of Rosacea Fulminans: A Comprehensive Review. Am J Clin Dermatol 2018; 19:79-86. [PMID: 28656562 DOI: 10.1007/s40257-017-0310-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Rosacea fulminans is a rare inflammatory condition of the central face marked by the abrupt onset of erythematous coalescing papules, pustules, nodules, and draining sinuses. Due to infrequent reporting in the literature, the pathophysiology, classification, and nomenclature of this condition remain controversial. This comprehensive review evaluated a total of 135 cases of rosacea fulminans for clinical and histopathologic features and reported treatment strategies. Patients were 91% female with an average age of onset of 31.3 years. Only 19% of cases reported duration of symptoms longer than 3 months, and reports of recurrence were uncommon. A majority of patients had history of rosacea or flushing, and common triggers included hormonal shifts, emotional stress, and medications. Extrafacial or systemic involvement was rare. Though oral and topical antibiotics were frequently utilized to treat rosacea fulminans, there was a clear shift in reported treatments for rosacea fulminans following the introduction of isotretinoin use in 1987, marked by increased reliance on isotretinoin in addition to topical and systemic corticosteroids. Newer treatments were associated with superior improvement compared with antibiotic monotherapy, most notably dramatically reduced rates of scarring, though reduced rates of disease recurrence were not evident. Several patterns revealed through this review reinforce the classification of rosacea fulminans as a severe yet distinct variant of rosacea and highlight key distinguishing clinical features and treatment options for optimal management.
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23
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Greywal T, Zaenglein AL, Baldwin HE, Bhatia N, Chernoff KA, Del Rosso JQ, Eichenfield LF, Levin MH, Leyden JJ, Thiboutot DM, Webster GF, Friedlander SF. Evidence-based recommendations for the management of acne fulminans and its variants. J Am Acad Dermatol 2017; 77:109-117. [DOI: 10.1016/j.jaad.2016.11.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/09/2016] [Accepted: 11/11/2016] [Indexed: 11/28/2022]
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24
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Perez M, Navajas-Galimany L, Antunez-Lay A, Hasson A. When strength turns into disease: acne fulminans in a bodybuilder. An Bras Dermatol 2017; 91:706. [PMID: 27828663 PMCID: PMC5087248 DOI: 10.1590/abd1806-4841.20165345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 12/16/2015] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mario Perez
- Pontificia Universidad Católica de Chile - Santiago, Chile
| | | | | | - Ariel Hasson
- Pontificia Universidad Católica de Chile - Santiago, Chile
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25
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Successful Treatment of Facial Acne Fulminans: Antimicrobial Agents and Oral Prednisolone as Promising Regimes. Case Rep Dermatol Med 2017; 2017:7092910. [PMID: 28428896 PMCID: PMC5385906 DOI: 10.1155/2017/7092910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 02/28/2017] [Accepted: 03/16/2017] [Indexed: 11/21/2022] Open
Abstract
Acne fulminans (AF), also known as acne maligna, is a rare painful ulcerative form of acne with an abrupt onset and systemic symptoms. Its incidence appears to be decreasing, possibly because of earlier and better treatment of acne. This report highlights a case on a necrotizing facial wound due to AF that was successfully treated with oral prednisolone and antimicrobial medication.
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26
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27
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McCarty M. Evaluation and Management of Refractory Acne Vulgaris in Adolescent and Adult Men. Dermatol Clin 2017; 34:203-6. [PMID: 27015780 DOI: 10.1016/j.det.2015.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Acne vulgaris alters the normal skin physiology, impairing stratum corneum and transepidermal water loss. A male's normal skin physiologic state is different than a female's and may have implications when choosing treatment when the skin is altered in a disease state. Transepidermal water loss, pH, and sebum production are different between the sexes. Several underlying conditions present in male acne patients at several ages that may require a more in-depth evaluation. As knowledge of the pathogenesis of acne expands, the differences in skin physiology between the sexes may alter the manner in which male patients with acne medications are approached.
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Affiliation(s)
- Morgan McCarty
- Department of Dermatology, Baylor Scott & White, 409 West Adams, Temple, TX 76501, USA.
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28
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Oranges T, Insalaco A, Diociaiuti A, Carnevale C, Strippoli R, Zambruno G, Tomà P, El Hachem M. Severe osteoarticular involvement in isotretinoin-triggered acne fulminans: two cases successfully treated with anakinra. J Eur Acad Dermatol Venereol 2016; 31:e277-e279. [DOI: 10.1111/jdv.14022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T. Oranges
- Department of Dermatology; Pisa University; Pisa Italy
| | - A. Insalaco
- Division of Rheumatology; Bambino Gesu Children's Hospital; IRCCS; Rome Italy
| | - A. Diociaiuti
- Division of Dermatology; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
| | - C. Carnevale
- Division of Dermatology; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
| | - R. Strippoli
- Department of Cellular Biotechnologies and Hematology; Section of Molecular Genetics; Sapienza University; Rome Italy
| | - G. Zambruno
- Division of Dermatology; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
| | - P. Tomà
- Department of Imaging; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
| | - M. El Hachem
- Division of Dermatology; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
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29
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Alakeel A, Ferneiny M, Auffret N, Bodemer C. Acne Fulminans: Case Series and Review of the Literature. Pediatr Dermatol 2016; 33:e388-e392. [PMID: 27699859 DOI: 10.1111/pde.12983] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Acne fulminans (AF) is a rare manifestation and the most severe form of the entire clinical spectrum of acne. The disease is destructive and is characterized by the sudden onset of painful and ulcerative pustules and systemic symptoms including high fever, hepatomegaly, polyarthralgia, leukocytosis, plaquetose, and increased inflammatory markers and transaminases. Osteolytic lesions in multiple skeletal sites could also be associated. The use of isotretinoin is considered a related trigger, as well as the use and cessation of testosterone, although a bacterial infection, a drug-induced disease, or an intake of anabolic androgenic steroids has been suggested. The treatment of AF is challenging and controversial. The recommended treatment is aggressive and consists of a combination of oral steroids and low doses of isotretinoin, with no consensus at this time. The patient may require several weeks of hospitalization to control the eruption. The cutaneous lesions usually leave scars and milia. We report on two boys and two girls presenting with AF, triggered by isotretinoin in three patients and by an antibiotic in one patient. All the patients treated with corticosteroids and isotretinoin with success.
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Affiliation(s)
- Abdullah Alakeel
- Department of Dermatology, Necker Enfants-Malades Hospital, Paris, France.,Department of Dermatology, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Marie Ferneiny
- Department of Dermatology, Necker Enfants-Malades Hospital, Paris, France
| | - Nicole Auffret
- Department of Dermatology, Necker Enfants-Malades Hospital, Paris, France
| | - Christine Bodemer
- Department of Dermatology, Necker Enfants-Malades Hospital, Paris, France
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30
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Didona D, Paolino G, Donati P, Muscardin LM. Resolution of nodulocystic acne with oral dapsone. Dermatol Ther 2016; 30. [DOI: 10.1111/dth.12406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Dario Didona
- First Division of Dermatology; Istituto Dermopatico dell'Immacolata; Roma Italy
| | - Giovanni Paolino
- Department of Dermatology; Sapienza-Università di Roma; Roma Italy
| | - Pietro Donati
- Dermatopathological Laboratory Institute “San Gallicano Institute of Rome”; Roma Italy
| | - Luca Maria Muscardin
- Dermatopathological Laboratory Institute “San Gallicano Institute of Rome”; Roma Italy
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31
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Rodríguez-Lomba E, Molina-López I, Monteagudo-Sáez I, Suárez-Fernández R, Campos-Domínguez M. A case of acne fulminans
with sacroiliitis successfully treated with methotrexate and isotretinoin. Dermatol Ther 2016; 29:476-478. [PMID: 27329214 DOI: 10.1111/dth.12382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Kim SY, Jung SK, Lee SG, Yi SM, Kim JH, Kim IH. Acne fulminans with osteolytic change in metaphysis of distal radius. Int J Dermatol 2015; 55:571-3. [PMID: 26712275 DOI: 10.1111/ijd.12065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 09/20/2012] [Accepted: 11/04/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Sun Yae Kim
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Sung Kyu Jung
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Geun Lee
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Sang Min Yi
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Jae Hwan Kim
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
| | - Il-Hwan Kim
- Department of Dermatology, Korea University Ansan Hospital, Ansan, Korea
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33
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Applications and limitations of lipid nanoparticles in dermal and transdermal drug delivery via the follicular route. Eur J Pharm Biopharm 2015; 97:152-63. [PMID: 26144664 DOI: 10.1016/j.ejpb.2015.06.020] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/10/2015] [Accepted: 06/08/2015] [Indexed: 01/22/2023]
Abstract
Lipid nanoparticles (LN) such as solid lipid nanoparticles (SLN) and nanolipid carriers (NLC) feature several claimed benefits for topical drug therapy including biocompatible ingredients, drug release modification, adhesion to the skin, and film formation with subsequent hydration of the superficial skin layers. However, penetration and permeation into and across deeper skin layers are restricted due to the barrier function of the stratum corneum (SC). As different kinds of nanoparticles provide the potential for penetration into hair follicles (HF) LN are applicable drug delivery systems (DDS) for this route in order to enhance the dermal and transdermal bioavailability of active pharmaceutical ingredients (API). Therefore, this review addresses the HF as application site, published formulations of LN which showed follicular penetration (FP), and characterization methods in order to identify and quantify the accumulation of API delivered by the LN in the HF. Since LN are based on lipids that appear in human sebum which is the predominant medium in HF an increased localization of the colloidal carriers as well as a promoted drug release may be assumed. Therefore, sebum-like lipid material and a size of less or equal 640 nm are appropriate specifications for FP of particulate formulations.
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34
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Grando LR, Leite OG, Cestari TF. Pseudo-acne fulminans associated with oral isotretinoin. An Bras Dermatol 2014; 89:657-9. [PMID: 25054758 PMCID: PMC4148285 DOI: 10.1590/abd1806-4841.20143024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/23/2013] [Indexed: 11/24/2022] Open
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.
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35
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Preparation of erythromycin-loaded poly(vinylalcohol) film and investigation of its feasibility as a transdermal delivery carrier. Tissue Eng Regen Med 2014. [DOI: 10.1007/s13770-014-0018-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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36
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Acne fulminans successfully treated with cyclosporine and isotretinoin. J Am Acad Dermatol 2014; 70:e38-9. [DOI: 10.1016/j.jaad.2013.09.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 09/25/2013] [Indexed: 11/15/2022]
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37
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Isotretinoin use and the risk of inflammatory bowel disease: a population-based cohort study. J Invest Dermatol 2012; 133:907-12. [PMID: 23096714 DOI: 10.1038/jid.2012.387] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Limited evidence suggests that isotretinoin may be associated with inflammatory bowel disease (IBD). To explore this association, we conducted a retrospective population-based cohort study in British Columbia, Canada, among participants who were newly treated with isotretinoin or topical acne medications. The entire population of untreated provincial residents aged 12-29 years served as the reference group. During the 12-year study period, we identified 46,922 participants treated with isotretinoin, 184,824 treated with a topical acne medication, and 1,526,946 untreated individuals. Compared with untreated individuals, we observed no significant association between isotretinoin use and IBD (rate ratio (RR) 1.14; 95% confidence interval (CI) 0.92-1.41). As expected, we found no association with topical acne medications (RR 1.11; 95% CI 0.99-1.24). In prespecified secondary analyses, isotretinoin was associated with IBD among individuals aged 12-19 years (RR 1.39; 95% CI 1.03-1.87) and topical acne medications were associated with ulcerative colitis (RR 1.19; 95% CI 1.00-1.42). Our primary analyses found no association between isotretinoin and IBD. In prespecified secondary analyses, some evidence was found of associations with isotretinoin as well as topical acne medications, suggesting a possible association between IBD and acne itself. Additional research is needed to explore this possibility.
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38
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Lages RB, Bona SH, Silva FVME, Gomes AKL, Campelo V. Acne fulminans successfully treated with prednisone and dapsone. An Bras Dermatol 2012; 87:612-4. [DOI: 10.1590/s0365-05962012000400015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 08/20/2011] [Indexed: 11/21/2022] Open
Abstract
Acne fulminans is a rare condition and the most severe form of acne. It involves the sudden onset of febrile and multisystemic symptoms, with poor response to ordinary therapy in patients who previously had mild to moderate acne. It is characterized by hemorrhagic ulcerative crusting lesions on the face, chest and upper back. The authors report a case of acne fulminans that was successfully treated with oral prednisone and dapsone.
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Affiliation(s)
| | | | | | | | - Viriato Campelo
- University of São Paulo; Federal University of Piaui, Brazil
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