Abstract

GUTIERREZ, Cecilia et al. Acne conglobata: a case report. AVFT [online]. 2014, vol.33, n.2, pp.51-59. ISSN 0798-0264.

Introduction: Acne conglobata (AC) is a rare form of acne and it is characterized by the development of a chronic infectious focus with severe local signs and the loss of the functional structure of the skin with confluent abscess and extensive scar tissue. Case description: A 18 year old male patient attended a medical consult due to skin lesions in face and thorax of 6 months of evolution, which were nodular with signs of inflammation and fistula accompanied by a purulent and fetid secretion, with important scaring tissue once resolved. Previously, the lesions were treated with thrimetropim/sulfametoxazol, ibuprofen and topic amikacin without satisfactory results. Bacteria cultures of the secretions were positive for Staphylococcus epidermidis and Streptococcus pyogenes. Meanwhile, hystopathologic studies confirmed the diagnosis of AC with findings corresponding with chronic inflammatory infiltration in the follicular wall in deep and superficial dermis. Treatment began with administration of systemic moxifloxacine for 2 weeks, and afterwards, topic erythromycin, clindamycin and azelaic acid, accompanied by orally administrated isotetrinoin. Nutritional and psychological support was also provided. After 2 months of treatment, significant improvement of the lesions could be seen and after 6 months they were completely resolved. Discussion: AC is a disease that has got physical and psychological consequences for the patient, especially in cases that show resistance to treatment. Proper care of this condition includes correct diagnosis and the use of antibiotics and retinoids as well as psychosocial therapy.

Keywords : Acne conglobata; Staphilococcus ssp; isotretinoin; macrolides; psychotherapy.