Acne fulminans is a rare and severe form of acne caused by Propionibacterium acnes, often linked to anabolic steroids and testosterone. Symptoms include joint inflammation, swollen lymph nodes, and difficulty breathing. Treatment involves oral steroids and isotretinoin. It was first described in 1958 and is most common in males aged 13 to 22 with a history of acne.
Acne fulminans (AF) is a severe but rare form of the acne skin disease that gets its name from the rapidity of its onset and the severity of its impact. The cause of acne fulminans is usually attributed to a type of bacteria called Propionibacterium acnes, which are antigens that some members of the medical community believe weaken the immune system and consequently allow atrial fibrillation to appear. The production or increase of Propionibacterium acnes is often linked to high levels of anabolic steroids and testosterone. In some cases, it can develop from unsuccessful treatment of acne conglobata itself. Other theories of disease precipitation include genetic factors and infectious diseases such as measles. Acne fulminans can also occur independently of any disease or factor.
In addition to the fever present with acne conglobata, acne fulminans is characterized by polyarthritis, which is inflammation of the joints and swollen lymph nodes at the base of the neck. These signs can make movement, particularly of the limbs and neck, very painful and difficult to perform. Some people may also experience difficulty breathing and open sores on the torso, which are prone to scarring and infection. In the later stages, the patient experiences weight, appetite and muscle loss as well as further deterioration in physical abilities. AF is most common among males aged 13 to 22 who have a history of acne.
Historically, acne fulminans is an extremely rare disease; only about 100 cases were reported within a 50-year period of its first description. Currently, the most common treatment for AF is a combined prescription of oral steroids and isotretinoin. Medicated soaps such as Dermisil are also popular with patients. Recurrence of AF after treatment is very rare.
Its discovery is commonly traced to 1958, when a pair of physicians with the surnames Burns and Colville attended the Detroit Dermatological Society with a teenager who had acute fevers and acne conglobata, which is also a skin disease. Acute febrile illness is characterized primarily by fever. Acne conglobata is a severe case of acne in which comedones, or blackheads, and ulcers are among the most common signs.
It was the first time such a case had been made public. For a while, the combination of the two aforementioned diseases was called acute febrile ulcerative acne conglobata, or acute febrile ulcerative acne. Acne fulminans, however, was eventually differentiated from acne conglobata due to the relatively sudden and severe nature of the disease, meaning it is fulminant. Indeed, the suffix “fulminant” of AF is derived from the adjective mentioned above.
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