Drug-Induced Acneiform Eruption

Abstract

Drug-induced acne is a specific subset of acne that usually has some specific features, namely a monomorphic pattern, an unusual location of the lesions beyond the seborrheic areas, an unusual age of onset, a resistance to conventional acne therapy and, of course, the notion of a recent drug introduction. Many drugs can be responsible for such a clinical pattern. Corticosteroids, neuropsychotherapeutic drugs, antituberculosis drugs, and immunomodulating molecules are the more classical drugs associated with induced acne. Recently, new drugs, mainly targeted therapy in the field of oncology, such as epidermal growth factor receptor inhibitors, have been associated with an increased frequency of this adverse effect. Disruption of the culprit drug is rarely mandatory in cases of drug-induced acne. Close cooperation between the dermatologist and medical staff in charge of the patient is an important challenge to achieve optimal management of the initial disease.

Drug-Induced Acneiform Eruptions

“…Lithium-induced acneiform eruptions are more frequent among men and those who are allergic to lithium [21]. No direct relation was shown between dose and severity of acne [2].…”

“…Although lesions usually begin to develop within 2-4 weeks after the administration of oral or topical therapy, they can also occur months after therapy. Dose, treatment duration, and individual factors may signiicantly afect the clinical presentation [2].…”

“…Hormonal contraceptive agents may induce or exacerbate acne [2]. A previous study demonstrated that 26.8% of women who used contraceptive etonogestrel implants developed acne [14].…”

“…Although AV pathogenesis is not clearly understood yet, increased sebum production, androgenic hormones, ductal hypercorniication, abnormal follicular keratinization, colonization of Propionibacterium acnes (P. acnes), inlammation, and genetic predisposition have been suggested to enhance acne development [1]. Hormone-dependent juvenile acne is a more frequent subgroup, whereas mechanical and drug-induced acne, which are particularly encountered during adulthood, are associated with the drug use with speciic underlying etiologies [2]. Acneiform drug eruptions represent a sudden-onset clinical presentation, where the comedones are not observed [3].…”

“…In addition, several drugs are known to be associated with drug-induced acneiform eruptions [2]. In particular, the development of new target-speciic molecules in the ield of oncology, such as epidermal growth factor receptor inhibitors (EGFRIs), has caused a signiicant increase in the incidence of drug-induced acneiform eruptions [2,3] (Table 1 This section focuses on the clinical and diferential characteristics of drug-induced acneiform eruptions, drugs which may lead to this clinical presentation, and available treatment options in the light of the current literature data.…”