Acne fulminans and bone lesions may present to other specialties

Acne fulminans is a rare form of acne vulgaris of acute onset, affecting mostly teenage boys and associated with a number of systemic symptoms and abnormal investigations. The occurrence of bone lesions in this condition is rare but well recognized, and often bone biopsies are performed to rule out malignancy or infection. We report a 13-year-old boy referred to the pediatric oncologists with multiple osteolytic bone lesions. He was noted to have severe acne. A potentially painful sternal bone biopsy was averted following dermatologic referral when a diagnosis of acne fulminans was made. Pediatricians and dermatologists need to be aware of this association so that unnecessary anguish and investigations can be avoided.