Acne Fulminans

The major characteristics of acne fulminans include sudden onset of ulcerating acne, which may be accompanied by fever and symptoms of polyarthritis.  Usually, acne fulminans does not respond well to conventional acne treatment, such as antibacterial therapy.  The most successful treatments appear to be debridement used in conjunction with steroid therapy. 

What causes Acne Fulminans? 

It appears that acne fulminans is caused by a weakened immune system and increased levels of testosterone and certain anabolic steroids.  These high levels of hormones cause an increase in the production and excretion of sebum and the acne-inducing bacteria known as propionibacterium acnes (P acnes).  Some skin professionals believe that isotretinoin may also precipitate an eruption of acne fulminans. 

How can you tell the difference between acne conglobata and acne fulminans? 

Although the physical symptoms may at first appear identical, acne fulminans is usually characterized by the presence of more physical pain.  Patients with this type of severe acne may describe feelings of bone or facial pain, migraines, and fever. 

Acne conglobata and acne fulminans also differ in the way they are treated.  Whilst acne conglobata may be treated with conventional anti-acne oral and topical agents, ance fulminans does not typically respond well to such treatments.  Acne fulminans responds better to steroid treatments. 

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