Case of acne conglobata successfully treated by CO₂ laser combined with topical tretinoin therapy

Abstract

Acne conglobata is an uncommon disorder characterized by the presence of nodulocystic lesions. Conservative therapy with oral and topical antibiotics is of limited efficacy in many cases, and surgical excision is often needed for removal of the cystic lesions. Treatment is particularly difficult in cases with lesions located in aesthetically sensitive areas, such as the face. We successfully treated a case of acne conglobata by CO(2) laser ablation to remove the top of the sinuses and their tracts. In addition, topical tretinoin therapy was also initiated simultaneously to prevent the appearance of new acne lesions. Based on the results, we propose that the use of CO(2) laser for opening the cysts, combined with topical tretinoin therapy to prevent the appearance of new lesions, is a powerful treatment option for acne conglobata.

Short‐term clinical effects of photodynamic therapy with topical 5‐aminolevulinic acid for facial acne conglobata: an open, prospective, parallel‐arm trial

“…Because acne conglobata can cause disfiguring scars if not treated, it must be aggressively managed. The treatments for acne conglobata includes oral isotretinoin, alone or in combination with systemic steroids , oral antibiotics, dapsone , infliximab , carbon dioxide laser , external beam radiation , and targeted therapies . Although some success can be achieved using these strategies, the results are not very satisfactory because of treatment resistance, scar formation, and severe adverse effects.…”

Acne conglobata successfully treated by fractional laser after CO2 laser abrasion of cysts combined with topical tretinoin

“…Conservative therapy with oral and topical antibiotics is usually ineffective. On the other hand, surgical excision is difficult for facial lesions 3,4 . We applied a CO 2 laser to open cysts, fistulas and abscesses, and drained the acne conglobata sinuses, as previously reported 5 .…”

“…3,4 We applied a CO 2 laser to open cysts, fistulas and abscesses, and drained the acne conglobata sinuses, as previously reported. 5 Although discharge of malodorous pus ceased after the CO 2 laser treatment, numerous concave scars persisted. Therefore, we additionally treated the patient with a fractional laser.…”

Acne Conglobata

“…After laser ablation, topical tretinoin therapy was also started simultaneously to prevent the appearance of new acne lesions. They proposed the CO(2) laser ablation with topical tretinoin as a powerful treatment option for acne conglobata [31]. They also reported another acne conglobata case, which they successfully treated by fractional laser after CO laser abrasion of cysts combined with topical tretinoin [32].…”