Definition: acute nodulocystic acne without systemic manifestations
Rare and severe form of acne
A definição de nódulos varia de país para país, refletindo variações nas agências nacionais de regulação de medicamentos, uma vez que a presença de nódulos determina o acesso a tratamento sistémico
Multiple and extensive inflammatory papules, tender nodules and abcesses which coalesce to form malodorous draining sinus tracts
Extensive disfiguring hypertrophic and atrophic scars
Typically on the trunk and upper limbs but frequently extend to the buttocks
No systemic features
A chronic and persistent course, extensive and disfiguring scarring
May occur in the context of existing papulopustular acne or may present as recrudescence of acne that has been in abeyance for many years
Predisposing factos: familial cases, can be triggered by testosterone, may be induced by anabolic steroid abuse, following exposure to aromatic hydrocarbons or ingestion of halogens
Management
Isotretinoin
Combined with antibiotics
Steroids
Intralesional steroids
Aspiration of large nodules
If unresponsive: dapsone, TNF alfa inhibitors (supported by case reports especially if follicular occlusion triad)
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