Acne with acute systemic reaction (acne fulminans?). Report of a case

A 17-year-old girl, hospitalized because of severe cystic acne of six weeks' duration, developed symptoms of systemic disease, with fever, accelerated erythrocyte sedimentation rate, leukocytosis, thrombocytosis, arthralgia and anemia. Extensive investigation ruled out other possible causes for the systemic involvement, and there was a prompt response to steroid therapy. This case had features similar to those associated with "acute, febrile, ulcerative conglobate acne with poly-arthralgia," except that there was an absence of ulcerative lesions: nonetheless, the dominant picture was that of cystic involvement. We believe that the use of the term "acne fulminans" for this and similar cases would be appropriate.