Acne fulminans
Overview
Course & target group: Acne fulminans is the most severe variant of acne conglobata with an acute systemic inflammatory course and predominantly affects male adolescents.
Clinical features: ulcerating, necrotizing lesions are present, accompanied by fever + polyarthralgia and hepatosplenomegaly.
Associations: Particularly with SAPHO syndrome as well as chronic inflammatory bowel diseases.
Therapy: Initial systemic glucocorticoid therapy, followed by cautious introduction of isotretinoin over several months, with a low starting dose.
- Bodybuilder acne fulminans / Doping-associated form: Anabolic steroids (testosterone derivatives, high protein supplement doses) are classic triggers of acne fulminans in muscular young men. What to look out for? CK levels + only moderate physical activity — under isotretinoin + intensive strength training, there is a risk of rhabdomyolysis. Discontinue anabolic steroids immediately.
Differential diagnoses
- Acne conglobata
- Erythema nodosum
- Pyoderma gangrenosum
- Abscess
- Carbuncle
- Acne vulgaris
- Rosacea fulminans / Pyoderma faciale
- SSSS (Staphylococcal Scalded Skin Syndrome)
Practise Acne fulminans in the app
Flashcards with spaced repetition, exam questions and spot-the-diagnosis on this topic – in DermaFuchs, free of charge.
In the DermaFuchs app: 7 flashcards · 1 clinical images
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More diseases of the skin appendages
- Hidradenitis suppurativa (acne inversa)
- Acne vulgaris
- Alopecia areata
- Androgenetic alopecia
- Folliculitis (infectious)
- Lichen planopilaris
- Milia (milium)
- Perioral dermatitis
Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.