Infantile acne

  • Onset 2-12 months of age
  • Clinical presentation
    • Comedones
    • Pitted scarring may occur
    • Deep suppurative nodules
  • Mechanism
    • Androgen production (testicles in boys due to LH, DHEA in adrenal in boys and girls)
    • Androgen levels decrease by 12 months of age
  • Approach
    • Assess for precocious puberty, abnormal growth
    • If suspicion order hand/wrist Xray to determine bone age
    • Hormonal labs
  • Rx
    • topical retinoids (tretinoin, adapalene)
    • Oral antibiotics (erythromycin, azithromycin) if severe
      • evitar tetraciclinas até aos 8 anos
    • Isotretinoin in recalcitrant (algumas guidelines dizem para evitar antes dos 12 anos)