Striae distensae are atrophic dermal scars associated with psychosocial stress. Several treatments have been used but there is no gold standard until now. Fractional photothermolysis has been described as a successful and safe method to treat scars. In this description, we report 4 patients (Fitzpatrick phototype IV) who developed striae distensae after long-term use of topical corticosteroids and were successfully treated with fractional nonablative 1540 nm Erbium: glass laser.
This pathology is a rare and serious form of acne vulgaris. Its treatment is a challenge because it does not respond satisfactorily to traditional acne therapies. Its diagnosis must be early so that the appropriate therapy is instituted quickly, avoiding sequelae. The case reported is a young male patient with acneic lesions associated with systemic manifestations and laboratory abnormalities. Treatment with prednisone and oral antibiotic therapy is instituted. After weaning from corticosteroid therapy, oral isotretinoin was introduced in a stepwise dose. The patient progresses with improvement of active lesions and cicatricial lesions on the back. The Acne Fulminans is destructive, begins with acute pain, with abrupt development of acneic lesions, hemorrhagic nodules and ulcerations with necrotic background, associated with systemic manifestations. The diagnosis is clinical. Therapy should be aggressive, involving oral corticosteroids with isotretinoin. Dapsone is also used as an antiinflammatory agent.
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