İzotretinoin tedavisi sırasında gelişen akne fulminans olgusu

Öz

Akne fulminans (AF), aknenin nadir rastlanan ülseratif bir varyantıdır. Ani başlayan şiddetli akneye sistemik semptomlar eklenir. 17 yaşında erkek hasta yüz ve göğüste sulantılı kabuklu yaralar, ateş ve kas ağrılarıyla başvurdu. Nodülokistik akne nedeniyle sistemik izotretinoin kullanımı mevcuttu. Tedaviden iki hafta sonra lezyonları ağrılı, ülseratif, hemorajik karakter kazanmıştı. Dermatolojik muayenede göğüs ve sırt bölgesinde şiddetli yer yer hemorajik krutla kaplı ülsere lezyonlar mevcuttu. Beyaz küre 17.500, eritrosit sedimentasyon hızı (ESH) 50 mm/ saat, C-reaktif protein (CRP) düzeyi 5,5 mg/L idi. Akne fulminans tanısı konularak sistemik izotretinoin tedavisi kesildi. 1 mg/kg oral prednizolon ve 300mg/gün klindamisin başlandı. Lezyonlarda gerileme görülen hastanın kortikosteroid tedavisi azaltılarak sonlandırıldı.

Anahtar Kelimeler

• Nodülokistik akne
• akne fulminans
• izotretinoin

Destekleyen Kurum

Bulunmamaktadır.

Etik Beyan

Olgudan yazılı onam alınmıştır.

A case of acne fulminans during isotretinoin treatment

Öz

Acne fulminans (AF) is a rare ulcerative variant of acne. Systemic symptoms are added to the sudden onset of severe acne. A 17-year-old male patient presented with watery crusted lesions on the face and chest, fever and myalgia. He was receiving systemic isotretinoin for nodulocystic acne. Two weeks after treatment, the lesions had become painful, ulcerated and hemorrhagic. Dermatological examination revealed severe ulcerated lesions on the chest and back covered with a hemorrhagic crust. White blood cell count was 17,500, erythrocyte sedimentation rate (ESR) was 50 mm/h, C-reactive protein (CRP) was 5.5 mg/L. Systemic isotretinoin treatment was discontinued with a diagnosis of acne fulminans. Oral prednisolone 1 mg/kg and clindamycin 300 mg/day were started. Lesions regressed and corticosteroid treatment was tapered and discontinued.

Anahtar Kelimeler

• NODULOCYSTIC ACNE
• acne fulminans
• isotretinoin

Kaynakça

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