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Acne fulminans and Cutibacterium acnes phylotypes
S Bocquet-Trémoureux1, S Corvec2,3, A Khammari1,2
1Department of Dermatology, CHU Nantes, Nantes, France.
Journal of the European Academy of Dermatology and Venereology : JEADV
|November 13, 2019
Summary
Acne fulminans (AF) is a severe acne characterized by ulceronecrotic lesions. This study found no specific Cutibacterium acnes phylotype in AF, suggesting abnormal immune activation may play a role. Biotherapies show promise for treatment.
Area of Science:
- Dermatology
- Microbiology
- Immunology
Background:
- Acne fulminans (AF) is a rare, severe inflammatory acne with ulceronecrotic lesions and potential systemic signs.
- Its pathophysiology and optimal treatment strategies remain incompletely understood.
Purpose of the Study:
- To characterize the clinical and biological profile of AF patients.
- To investigate Cutibacterium acnes phylotype distribution in AF compared to acne vulgaris.
- To evaluate the efficacy of various therapeutic interventions for AF.
Main Methods:
- Retrospective observational study of 15 AF patients (2008-2018).
- Bacteriological sampling for C. acnes phylotype analysis.
- Therapeutic response assessment using ECLA and GEA scales.
Main Results:
- Median age 15 years, 80% male; 60% had isotretinoin-induced AF.
- C. acnes positive in 80%; IA1 phylotype predominated (60%), similar to acne vulgaris.
- Only 33.3% achieved remission with first-line corticosteroids; 5/7 patients responded to biotherapy (secukinumab).
Conclusions:
- No specific C. acnes phylotype is associated with AF, suggesting abnormal innate immune activation.
- Further research is needed on preventive strategies, combined treatments, and the role of biotherapies (e.g., anti-IL-17) in AF management.
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