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A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report

Acne fulminans (AF) is a rare and highly inflammatory severe form of acne most commonly seen in adolescent males. Unlike acne vulgaris, AF presents with associated systemic manifestations including, but not limited to, malaise, myalgia, arthralgia, fever, anorexia, and weight loss. It is often an ex...

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Autores principales: Rajaii, Roxanne, Globerson, Jeff, Arnold, Nichelle, Mahon, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MSU College of Osteopathic Medicine Statewide Campus System 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746097/
https://www.ncbi.nlm.nih.gov/pubmed/33655144
http://dx.doi.org/10.51894/001c.7003
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author Rajaii, Roxanne
Globerson, Jeff
Arnold, Nichelle
Mahon, Michael
author_facet Rajaii, Roxanne
Globerson, Jeff
Arnold, Nichelle
Mahon, Michael
author_sort Rajaii, Roxanne
collection PubMed
description Acne fulminans (AF) is a rare and highly inflammatory severe form of acne most commonly seen in adolescent males. Unlike acne vulgaris, AF presents with associated systemic manifestations including, but not limited to, malaise, myalgia, arthralgia, fever, anorexia, and weight loss. It is often an extremely painful condition of sudden onset and can occur years after mild or moderate acne vulgaris. While the inciting agent for this condition has been postulated to be an explosive hypersensitivity reaction to the bacterium Propionobacterium acnes, increased androgens, namely testosterone, have also been reported to play a role in the pathogenesis of this disease process. Additionally, environmental triggers such as air pollution and exposure to halogenated hydrocarbons during occupational activities in enclosed, high temperature settings have been identified as possible etiologies or exacerbating factors. AF is primarily a clinical diagnosis. Isotretinoin, in combination with systemic steroids, are generally the treatments of choice for this disease entity. A Caucasian male in his early 40’s presented to the authors’ clinic with a chief complaint of painful acneiform nodules, cysts, papules, pustules, and abscesses on his back, chest, neck, shoulders, upper arms, and thighs for several months. This case report demonstrates a refractory case of AF with significant clinical improvement after six weeks of topical treatment with subcutaneous adalimumab in combination with oral doxycycline. This case provides evidence supporting the role of Adalimumab in the treatment of AF in addition to the other inflammatory conditions currently FDA approved for treatment with this tumor-necrosis factor (TNF) alpha inhibitor. These conditions include plaque psoriasis, Crohn’s disease, hidradenitis suppurativa, psoriatic arthritis, and rheumatoid arthritis.
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spelling pubmed-77460972021-03-01 A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report Rajaii, Roxanne Globerson, Jeff Arnold, Nichelle Mahon, Michael Spartan Med Res J Case Report Acne fulminans (AF) is a rare and highly inflammatory severe form of acne most commonly seen in adolescent males. Unlike acne vulgaris, AF presents with associated systemic manifestations including, but not limited to, malaise, myalgia, arthralgia, fever, anorexia, and weight loss. It is often an extremely painful condition of sudden onset and can occur years after mild or moderate acne vulgaris. While the inciting agent for this condition has been postulated to be an explosive hypersensitivity reaction to the bacterium Propionobacterium acnes, increased androgens, namely testosterone, have also been reported to play a role in the pathogenesis of this disease process. Additionally, environmental triggers such as air pollution and exposure to halogenated hydrocarbons during occupational activities in enclosed, high temperature settings have been identified as possible etiologies or exacerbating factors. AF is primarily a clinical diagnosis. Isotretinoin, in combination with systemic steroids, are generally the treatments of choice for this disease entity. A Caucasian male in his early 40’s presented to the authors’ clinic with a chief complaint of painful acneiform nodules, cysts, papules, pustules, and abscesses on his back, chest, neck, shoulders, upper arms, and thighs for several months. This case report demonstrates a refractory case of AF with significant clinical improvement after six weeks of topical treatment with subcutaneous adalimumab in combination with oral doxycycline. This case provides evidence supporting the role of Adalimumab in the treatment of AF in addition to the other inflammatory conditions currently FDA approved for treatment with this tumor-necrosis factor (TNF) alpha inhibitor. These conditions include plaque psoriasis, Crohn’s disease, hidradenitis suppurativa, psoriatic arthritis, and rheumatoid arthritis. MSU College of Osteopathic Medicine Statewide Campus System 2018-09-26 /pmc/articles/PMC7746097/ /pubmed/33655144 http://dx.doi.org/10.51894/001c.7003 Text en https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (4.0) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Case Report
Rajaii, Roxanne
Globerson, Jeff
Arnold, Nichelle
Mahon, Michael
A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report
title A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report
title_full A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report
title_fullStr A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report
title_full_unstemmed A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report
title_short A Novel Treatment of Acne Fulminans with Adalimumab: A Case Report
title_sort novel treatment of acne fulminans with adalimumab: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746097/
https://www.ncbi.nlm.nih.gov/pubmed/33655144
http://dx.doi.org/10.51894/001c.7003
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