Rapid-onset oral isotretinoin-induced acne fulminans without systemic symptoms in a male adolescent

Pinar Incel Uysal

doi:10.7241/ourd.20214.14

Abstract

Isotretinoin-induced acne fulminans without systemic symptoms (IIAF-WOSS) is an uncommon clinical variant of acne, not exhibiting systemic symptoms but with potentially severe skin lesions. Some authors believe that its occurrence is dose-dependent. Herein, we present the case of a sixteen-year-old boy with IIAF-WOSS, which developed two weeks after starting treatment with isotretinoin 0.6 mg/kg/day. The patient was successfully treated with a systemic steroid. IIAF-WOSS may cause significant disfiguring scarring, thus the physician needs to be aware of this condition, even early with low doses of isotretinoin.

Highlights

Acne fulminans (AF) is a rare and severe variant of inflammatory acne characterized by abrupt-onset nodules, painful erosions, and hemorrhagic crusts
Once the lesions began healing in week two of 0.8 mg/kg/day doses, oral isotretinoin 0.1 mg/day was restarted
© Our Dermatol Online 4.2021 www.odermatol.com studies addressing the optimal management of this rare entity

Summary

Introduction

Acne fulminans (AF) is a rare and severe variant of inflammatory acne characterized by abrupt-onset nodules, painful erosions, and hemorrhagic crusts. Systemic symptoms, including fever, malaise, and arthralgias, may develop in its most severe forms. Isotretinoin-induced AF without systemic symptoms (IIAF-WOSS) is increasing in frequency due to widespread use of the drug. Due to the persistence of the crusted lesions in week two of the treatment, the dose was increased to 0.8 mg/kg/day.

Results

Conclusion