Acneiform eruption

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Acneiform eruption
Patient with facial angiofibromas caused by tuberous sclerosis.jpg
Facial angiofibromas caused by tuberous sclerosis mimicking acne
Specialty Dermatology
Symptoms Small bumps resembling acne [1]

Acneiform eruptions, or acne mimicking eruptions, are a group of skin conditions characterized by small bumps resembling acne. [1] Typically, these bumps are mostly of similar size. [1] Some bumps may be bigger or contain fluid. [2] Generally, blackheads and whiteheads are absent. [2] It tends to appear suddenly, with the chest and back most frequently affected. [2]

Contents

Causes include cosmetics, the application of greasy products, and some medicines. [1] Repeated rubbing of skin and pressure are other triggers. [2] The facial bumps of tuberous sclerosis can resemble acne. [2] Any age can be affected. [2]

Signs and symptoms

Papules and pustules with no true comedones are mostly found on the trunk and back. Nodulocystic lesions are uncommon. In contrast to acne, these lesions can appear anywhere on the body, not just on the face. When the cause is a drug eruption, the individual will usually specify that the lesions go away once the medication is stopped. [2]

Causes

Infections, changes in hormones or metabolism, genetic disorders, drug reactions, chemical contact, friction, and pressure can all cause acne-like eruptions. [2]

In general, drugs that cause acneiform eruptions can aggravate or cause the reappearance of pre-existing acne. The most common type of drug-induced acne is steroid acne. It is seen as a side effect of glucocorticosteroid treatment and also after steroid inhalation. It almost always happens a few weeks after starting the therapy. [3]

Acneiform eruptions can also be caused by other hormones. Corticotropin can cause papules, but only after prolonged exposure. Acneiform eruptions can also occur when natural androgens, such as testosterone, are used in overly tall boys, or when synthetic androgens, such as danazol, are used. [4]

Certain anticonvulsant medications can also aggravate pre-existing acne or trigger acneiform eruptions following a few weeks. This is a side effect of hydantoins, trimethadione, primidone, and phenobarbital. Dantrolene is a hydantoin derivative that can aggravate acne or cause acneiform eruptions.

A number of psychopharmacological drugs have been linked to acneiform eruptions. This effect is seen with phenothiazines, diazepam, and chloral hydrate, but particularly with lithium carbonate. [3]

Diagnosis

Acneiform eruptions differentiate themselves from acne vulgaris by a history of sudden onset, a monomorphic morphology, eruption development at any age, affecting the trunk more frequently than the face, not always affecting sebaceous areas of the body, and the rarity of cyst formation. In most cases, the diagnosis is made clinically, but if there is any doubt, a biopsy or culture of any discharge may be obtained. Another method for making a diagnosis is to withdraw the suspected medication. [2]

Related Research Articles

<span class="mw-page-title-main">Acne</span> Skin condition characterized by pimples

Acne, also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to lack of confidence, anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.

<span class="mw-page-title-main">Hidradenitis suppurativa</span> Human disease

Hidradenitis suppurativa (HS), sometimes known as acne inversa or Verneuil's disease, is a long-term dermatological condition characterized by the occurrence of inflamed and swollen lumps. These are typically painful and break open, releasing fluid or pus. The areas most commonly affected are the underarms, under the breasts, perineum, buttocks, and the groin. Scar tissue remains after healing. HS may significantly limit many everyday activities, for instance, walking, hugging, moving, and sitting down. Sitting disability may occur in patients with lesions in sacral, gluteal, perineal, femoral, groin or genital regions; and prolonged periods of sitting down can also worsen the condition of the skin of these patients.

<span class="mw-page-title-main">Chloracne</span> Medical condition

Chloracne is an acneiform eruption of blackheads, cysts, and pustules associated with exposure to certain halogenated aromatic compounds, such as chlorinated dioxins and dibenzofurans. The lesions are most frequently found on the cheeks, behind the ears, in the armpits and groin region.

<span class="mw-page-title-main">Rosacea</span> Skin condition, usually on the face

Rosacea is a long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels. Often, the nose, cheeks, forehead, and chin are most involved. A red, enlarged nose may occur in severe disease, a condition known as rhinophyma.

<span class="mw-page-title-main">Perioral dermatitis</span> Medical condition

Perioral dermatitis, also known as periorificial dermatitis, is a common type of inflammatory skin rash. Symptoms include multiple small (1–2 mm) bumps and blisters sometimes with background redness and scale, localized to the skin around the mouth and nostrils. Less commonly, the eyes and genitalia may be involved. It can be persistent or recurring, and resembles particularly rosacea and to some extent acne and allergic dermatitis. The term "dermatitis" is a misnomer because this is not an eczematous process.

Acne is acneiform eruptions. It is usually used as a synonym for acne vulgaris, but may also refer to:

Fox–Fordyce disease (FFD) is a chronic blockage of the sweat gland ducts with a secondary, non-bacterial inflammatory response to the secretions and cellular debris in the cysts. The inflammation is often accompanied by intense itching. In general, the disease often causes skin to darken near the affected area and raised bumps or papules to appear. In addition, hair follicles can become damaged which cause hair loss. Hidradenitis is very similar, but tends to have a secondary bacterial infection so that pus-draining sinuses are formed. It is a very devastating skin disease that does not have universally curative treatments.

Acne cosmetica is a type of contact acneiform eruption caused by or aggravated by cosmetics. Signs and symptoms include a dense group of similar sized closed comedones and scattered small bumps, typically over the skin where the cosmetic has been applied. Flare-ups do not generally occur shortly before menstruation and open comedones are not common. There may be associated perioral dermatitis.

Acne medicamentosa is acne that is caused or aggravated by medication. Because acne is generally a disorder of the pilosebaceous units caused by hormones, the medications that trigger acne medicamentosa most frequently are hormone analogs. It is also often caused by corticosteroids; in this case, it is referred to as steroid acne.

<span class="mw-page-title-main">Steroid rosacea</span> Medical condition

Steroid-induced rosacea is an iatrogenic condition from the use of either systemic steroid or topical steroids. It is nearly identical to steroid induced acne from the standpoint of etiology.

Steroid acne is an adverse reaction to corticosteroids, and presents as small, firm follicular papules on the forehead, cheeks, and chest. Steroid acne presents with monomorphous pink paupules, as well as comedones, which may be indistinguishable from those of acne vulgaris. Steroid acne is commonly associated with endogenous or exogenous sources of androgen, drug therapy, or diabetes and is less commonly associated with HIV infection or Hodgkin's disease.

Acne aestivalis also called as acne mallorca, is a special kind of polymorphous light eruption induced by ultra violet A radiation. This condition is said to be seasonal, usually affecting people in springtime and goes away in autumn when there is less sun light. This photo induced skin reaction leads to a mono-morphous eruption that consists of multiple, uniform, red, papular lesions. This skin reaction is classified as a delayed-type hypersensitivity because the onset is 24–72 hours after sun exposure. The condition equally affects men and women between the ages of 20–40 years old with no prior history of acne vulgaris. The eruption is unusual because it spares the face but it affects the lateral aspects of the upper arms, shoulder girdle, back, and chest. This condition's pathogenesis is not very well understood but scientists believe it an unfortunate side effect that results from a strong immune response to potentially cancer-causing cell damage.

<span class="mw-page-title-main">Neonatal acne</span> Medical condition

Neonatal acne, also known as acne neonatorum, is a type of acne that develops in newborns, typically within the first six weeks of life. It presents with open and closed comedones on the cheeks, chin and forehead.

Pomade acne is a type of acne cosmetica that appears as a group of small bumps close to the hairline on the forehead, frequently seen in black skin.


Acne necrotica presents with a primary lesion that is a pruritic or painful erythematous follicular-based papule that develops central necrosis and crusting and heals with a varioliform scar.

<span class="mw-page-title-main">Pimple</span> Type of comedo

A pimple or zit is a kind of comedo that results from excess sebum and dead skin cells getting trapped in the pores of the skin. In its aggravated state, it may evolve into a pustule or papule. Pimples can be treated by acne medications, antibiotics, and anti-inflammatories prescribed by a physician, or various over the counter remedies purchased at a pharmacy.

<span class="mw-page-title-main">Pilar sheath acanthoma</span> Medical condition

A pilar sheath acanthoma is a cutaneous condition most often found on the face, particularly above the upper lip in adults. Pilar sheath acanthoma is a skin-colored, 5-10 mm diameter papule or nodule with a keratin-filled pore in the center. Pilar sheath acanthoma diagnosis confirmed by shave or excisional biopsy. Successful treatment requires surgical excision.

Infantile acne is a form of acne that begins in very young children. Typical symptoms include inflammatory and noninflammatory lesions, papules and pustules most commonly present on the face. No cause of infantile acne has been established but it may be caused by increased sebaceous gland secretions due to elevated androgens, genetics and the fetal adrenal gland causing increased sebum production. Infantile acne can resolve by itself by age 1 or 2. However, treatment options include topical benzyl peroxide, topical retinoids and topical antibiotics in most cases.

<span class="mw-page-title-main">Sebaceous filament</span> Medical condition

A sebaceous filament is a tiny collection of sebum and dead skin cells around a hair follicle, which usually takes the form of a small, yellow to off-white hair-like strand when expressed from the skin.

Childhood granulomatous periorificial dermatitis (CGPD) is a rare benign granulomatous skin disease of unknown cause. The disorder was first described in 1970 by Gianotti in a case series of five children. CGPD is more common in boys than girls.

References

  1. 1 2 3 4 Plewig, Gerd; Melnik, Bodo; Chen, WenChieh (2019). "9 Acne mimicking diseases". Plewig and Kligman ́s Acne and Rosacea. Switzerland: Springer. p. 299-404. ISBN   978-3-319-49273-5.
  2. 1 2 3 4 5 6 7 8 9 Nair, Pragya A.; Salazar, Francisco J. (July 31, 2023). "Acneiform Eruptions". StatPearls Publishing. PMID   29083685 . Retrieved November 17, 2023.
  3. 1 2 Plewig, Gerd; Kligman, Albert M. (2000). "Acneiform Eruptions". Acne and rosacea. Berlin, Heidelberg: Springer Berlin Heidelberg. p. 432–439. doi:10.1007/978-3-642-59715-2_50. ISBN   978-3-540-66751-3 . Retrieved November 16, 2023.
  4. Du-Thanh, Aurélie; Kluger, Nicolas; Bensalleh, Houdna; Guillot, Bernard (2011). "Drug-Induced Acneiform Eruption". American Journal of Clinical Dermatology. 12 (4). Springer Science and Business Media LLC: 233–245. doi:10.2165/11588900-000000000-00000. ISSN   1175-0561 . Retrieved November 16, 2023.