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Acne inversa complicated by Actinomyces neuii

Jakob Nedomansky1, Doris Weiss2, Birgit Willinger3

  • 1Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.

Infection
|July 2, 2015
PubMed
Abstract

Insights

This case study identifies Actinomyces neuii as a rare cause of recurring acne inversa (AI). Prompt antibiotic treatment for this infection led to sustained remission, highlighting the importance of diagnosing superinfections in AI management.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Microbiology

Background:

  • Acne inversa (AI) is a chronic inflammatory skin condition affecting intertriginous areas.
  • AI is characterized by pain, drainage, malodor, and scarring, often involving secondary bacterial superinfections.
  • The pathogenesis of AI is thought to involve autoimmune reactions, but superinfections play a significant role.

Observation:

  • A unique case involved a 43-year-old male with a recurring AI lesion in the left axilla.
  • A bacterial swab identified Actinomyces neuii as the sole pathogen in the lesion.

Findings:

  • The patient received Amoxicillin/Clavulanic Acid, leading to lesion clearance and negative intraoperative swabs for A. neuii.
  • Following a 4-week antibiotic course, the patient remained relapse-free for over 12 months post-surgical excision.

Implications:

  • This case highlights the rare co-occurrence of AI and cutaneous Actinomycosis.
  • Failure to identify slow-growing pathogens like Actinomyces spp. may increase AI recurrence rates, emphasizing the need for thorough infection workup before immunosuppressive therapy.
Keywords:
Acne inversaActinomyces neuiiActinomycosisHidradenitis suppurativaSoft tissue infection

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