Acne Fulminans: Case Series and Review of the Literature

Alakeel, Abdullah; Ferneiny, M.; Auffret, N.; Bodemer, Christine

doi:10.1111/pde.12983

Cited by 26 publications

(16 citation statements)

References 14 publications

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“…4 Although acne vulgaris is a ubiquitous disease, AF is rarely reported, with about 200 cases documented in the literature. [1][2][3][7][8][9] The incidence of publications has gradually decreased between its first description and the 2010s, which may reflect a lower occurrence of severe forms with systemic signs or suggest an absence of progression in the knowledge of the pathophysiology of this disease and its treatment.…”

Section: Introductionmentioning

confidence: 99%

Acne fulminans and Cutibacterium acnes phylotypes

Bocquet-Trémoureux

Corvec

Khammari

et al. 2020

Acad Dermatol Venereol

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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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Section: Introductionmentioning

confidence: 99%

Acne fulminans and Cutibacterium acnes phylotypes

Bocquet-Trémoureux

Corvec

Khammari

et al. 2020

Acad Dermatol Venereol

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“…AF may occur after high doses of isotretinoin when initiating treatment in patients with severe acne 34 . Also, elevated levels of testosterone may play a role in its pathogenesis 35 …”

Section: Resultsmentioning

confidence: 99%

Truncal acne, what do we know?

Poli¹,

Auffret²,

Leccia

et al. 2020

Acad Dermatol Venereol

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Truncal acne is frequently overlooked in dermatological practice, even though it may result in scars and impact on self-esteem and body image. Therefore, it is important to identify the disease early in order to initiate treatment in time and, thus, to prevent it from worsening and resulting in physical and psychological sequelae. The aim of this review is to provide an overview of what is currently known about truncal acne, its prevalence, aetiology and physiopathology, how its severity is currently evaluated, how to differentiate it from other skin afflictions and current treatment options. A review of literature considering the issue of truncal acne published up to 2019 and available from PubMed was conducted, and in total, 76 articles were selected from PubMed. Currently, only little information about truncal acne is available. Considered as having the same pathophysiology as facial acne, the clinical picture and treatment response seem to differ. Specific acne severity grading systems and quality of life questionnaires as well as a specific treatment algorithm are still lacking. Filling this gap should allow clinicians to assess truncal acne in the best possible way, choosing suitable treatment options, helping patients to improve treatment adherence and quality of life and finally allowing a better management of truncal acne. In conclusion, more knowledge is required to treat more efficiently truncal acne.

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“…30 Acne fulminans can be either triggered or rarely precipitated during isotretinoin therapy. However, a literature review by Alakeel study group 31 on the acne fulminans demonstrated no kidney involvement in isotretinoin recipients.…”

Section: Discussionmentioning

confidence: 99%

<p>Isotretinoin and the Kidney: Opportunities and Threats</p>

Forouzani-Haghighi

Karimzadeh

2020

CCID

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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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Acne Fulminans: Case Series and Review of the Literature

Cited by 26 publications

References 14 publications

Acne fulminans and Cutibacterium acnes phylotypes

Acne fulminans and Cutibacterium acnes phylotypes

Truncal acne, what do we know?

<p>Isotretinoin and the Kidney: Opportunities and Threats</p>

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