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Acne fulminans with bone lesions
Abstract:
We present 5 young men who developed acne fulminans. During the acute, febrile illness, all had musculoskeletal symptoms, and X-ray and bone scan examinations revealed that 4 of the patients had osteolytic bone lesions. The disease was resistant to various antibiotics and one patient needed surgical trepanation of the sternum. No evidence of sepsis or bacterial osteomyelitis was found, as all bacteriological cultures proved negative and the tissue reaction was unspecific. The dermatopathogenetic origin of bone lesions in the present patients seems evident, but speculation that the etiology depends on immune mechanisms remains open.
Insights
Acne fulminans in young men can cause severe bone lesions and musculoskeletal pain. This rare condition may involve immune system responses, not bacterial infections.
Area of Science:
- Dermatology
- Rheumatology
- Pathology
Background:
- Acne fulminans is a rare, severe variant of acne vulgaris.
- It presents with acute febrile illness and characteristic skin lesions.
Observation:
- Five young men with acne fulminans experienced musculoskeletal symptoms.
- Radiographic and bone scan imaging revealed osteolytic bone lesions in four patients.
- The condition was unresponsive to antibiotics, with one requiring sternal trepanation.
Findings:
- Bacteriological cultures were negative, ruling out sepsis or bacterial osteomyelitis.
- Histopathology showed unspecific tissue reactions.
- The bone lesions appeared to be dermatopathogenetically linked to acne fulminans.
Implications:
- The findings suggest a potential immune-mediated etiology for bone involvement in acne fulminans.
- Further research into immune mechanisms is warranted.
- This highlights the importance of considering systemic complications in acne fulminans.