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Acne Conglobata
What is acne conglobata?
Acne conglobata is a severe form of cystic acne, typically
involving the trunk more than the face. Nodules and cysts often coalesce forming
abscesses, draining sinuses and ulcerations. Severe scars can form leading to
disfigurement. The cause is unknown, though it is occasionally associated
with the XYY chromosomal abnormality. It has been reported as part of the
genetic PAPA syndrome (pyogenic arthritis,
pyoderma gangrenosum, and acne.) Exposure to androgens or anabolic steroids
is occasionally implicated. Onset is typically following puberty, with new
lesion formation continuing through the fourth decade of life.
With what can acne conglobata be confused?
Acne conglobata can be confused with acne fulminans,
acne vulgaris, acne-like eruptions such as
steroid acne, and occupational acne and exposures
to halogens (halogenoderma) or dioxin. The fungal infection sporotrichosis
has also been described in the differential diagnosis.
How is acne conglobata diagnosed?
Acne conglobata is diagnosed by history and physical exam.
A typical feature of the disease is open comedones (blackheads) that appear in
pairs or clusters.
How is acne conglobata treated?
Acne conglobata is treated with oral
isotretinoin (Accutane) as well as with
the topical therapies described for acne vulgaris.
Systemic steroid (prednisone) may also be
helpful. Oral antibiotics such as
tetracycline or erythromycin may
also be used. Resistant cases may respond to
dapsone. Large lesions can be injected with
intralesional triamcinolone. Surgical intervention to remove large
confluent nodules and sinus tracts is sometimes necessary.
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What is the prognosis for acne conglobata?
Acne conglobata can cause sever scarring and disfigurement and
attendant psychological consequences. Treatment should be started as early as
possible to prevent scarring and psychological consequences.
Date created 05/24/2008
Last updated
05/24/2008
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