Acne conglobata is a highly inflammatory disease presenting with
comedones
A comedo (plural comedones) is a clogged hair follicle (pore) in the skin. Keratin (skin debris) combines with oil to block the follicle. A comedo can be open (blackhead) or closed by skin (whitehead) and occur with or without acne. The word ''com ...
,
nodules,
abscess
An abscess is a collection of pus that has built up within the tissue of the body, usually caused by bacterial infection. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pre ...
es, and draining sinus tracts.
This condition generally begins between the ages of 18 and 30. It usually persists for a very long time, and often until the patient is around 40 years old. Although it often occurs where there is already an active
acne
Acne ( ), also known as ''acne vulgaris'', is a long-term Cutaneous condition, skin condition that occurs when Keratinocyte, dead skin cells and Sebum, oil from the skin clog hair follicles. Typical features of the condition include comedo, ...
problem, it can also happen to people whose acne has subsided. Although the cause of this type of acne is unknown, it is associated with
testosterone
Testosterone is the primary male sex hormone and androgen in Male, males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testicles and prostate, as well as promoting se ...
and thus appears mainly in males. It can be caused by
anabolic steroid
Anabolic steroids, also known as anabolic-androgenic steroids (AAS), are a class of drugs that are structurally related to testosterone, the main male sex hormone, and produce effects by binding to the androgen receptor (AR). Anabolism, Anaboli ...
abuse and sometimes appears in males after stopping testosterone therapy. It can also happen to someone who has a tumor that is releasing large amounts of androgens, or to people in remission from diseases, such as
leukemia
Leukemia ( also spelled leukaemia; pronounced ) is a group of blood cancers that usually begin in the bone marrow and produce high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or '' ...
. In certain persons, the condition may be triggered by exposure to aromatic hydrocarbons or ingestion of halogens.
Presentation
Acne conglobata is a severe, inflammatory variant of acne. Inflammatory papules, papulonodules, nodules and pustules may coalesce, and abscesses in the skin may form sinuses that interconnect.
Bleeding or draining of acneiform plaques may be present. The systemic findings seen in
acne fulminans are not present. A component of the
follicular occlusion tetrad, acne conglobata may be seen with
hidradenitis suppurativa
Hidradenitis suppurativa (HS), sometimes known as acne inversa or Verneuil's disease, is a long-term dermatological condition characterized by the occurrence of inflamed and swollen lesions, lumps. These are typically painful and break open, r ...
,
pilonidal disease
Pilonidal disease is a type of skin infection that typically occurs as a cyst Intergluteal cleft, between the cheeks of the buttocks and often at the upper end. Symptoms may include pain, swelling, and redness. There may also be drainage of fluid ...
and
dissecting cellulitis of the scalp.
The face, chest, back and buttocks may be involved.
Treatment
The most common treatment is the acne medication
isotretinoin
Isotretinoin, also known as 13-''cis''-retinoic acid and sold under the brand name Accutane among others, is a medication used to treat skin diseases like harlequin-type ichthyosis, and lamellar ichthyosis, and severe cystic acne or moderat ...
. It may be combined with
prednisone
Prednisone is a glucocorticoid medication mostly used to immunosuppressive drug, suppress the immune system and decrease inflammation in conditions such as asthma, COPD, and rheumatologic diseases. It is also used to treat high blood calcium ...
. Antibiotics such as
dapsone
Dapsone, also known as 4,4'-sulfonyldianiline (SDA) or diaminodiphenyl sulfone (DDS), is an antibiotic commonly used in combination with rifampicin and clofazimine for the treatment of leprosy. It is a second-line medication for the treatment an ...
,
tetracycline
Tetracycline, sold under various brand names, is an antibiotic in the tetracyclines family of medications, used to treat a number of infections, including acne, cholera, brucellosis, plague, malaria, and syphilis. It is available in oral an ...
or
erythromycin
Erythromycin is an antibiotic used for the treatment of a number of bacterial infections. This includes respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. It may also be used ...
may also be prescribed. An option to treat with carbon dioxide laser therapy, followed by topical tretinoin therapy has been described.
Surgery may be necessary to remove large nodules. Alternatively, nodules can be injected with
corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are invo ...
s such as
triamcinolone.
See also
*
List of cutaneous conditions
Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the Human body, body and composed of Human skin, skin, hair, Nail (anatomy), nails, and related muscle and glands. The major function o ...
References
External links
{{Disorders of skin appendages
Acneiform eruptions