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Osteomyelitis-like bone lesions in acne fulminans
S L Pauli1, T Valkeakari, L Räsänen
1Department of Dermatology, University Central Hospital, Tampere, Finland.
European Journal of Pediatrics
|November 1, 1989
Summary
Acne fulminans (AF) can cause severe skin lesions and bone issues in young males. Combination treatment with prednisolone effectively managed these symptoms, even in relapses, suggesting its therapeutic role.
Area of Science:
- Dermatology
- Rheumatology
- Pediatrics
Background:
- Acne fulminans (AF) is a rare, severe form of acne vulgaris.
- AF typically presents with sudden onset of inflammatory papules, pustules, and ulcerations.
- Musculoskeletal involvement is an uncommon but recognized complication of AF.
Observation:
- Two young male patients with AF presented with severe skin lesions and osteolytic bone lesions in the clavicles.
- These bone lesions were bacteriologically negative, initially leading to suspicion of septic infections.
- Initial antibiotic treatment for suspected infections yielded unsatisfactory results in both cases.
Findings:
- Combination therapy with prednisolone was initiated for both patients.
- A favorable clinical response was observed in both patients following prednisolone treatment.
- The first patient experienced a relapse, which was successfully managed with steroids alone.
Implications:
- Corticosteroids, such as prednisolone, appear to be effective in managing both the dermatological and musculoskeletal manifestations of acne fulminans.
- The findings suggest that bone lesions in AF may have an inflammatory or autoimmune basis rather than a septic origin.
- Further research into the pathomechanism of bone lesions in AF is warranted to guide optimal treatment strategies.