Acne fulminans in Marfan syndrome.(CASE REPORTS)

Abstract

We report on a 12-year-old boy suffering from acne fulminans in combination with Marfan syndrome. The trigger for acne induction seemed to be a testosterone therapy. The particular therapeutic problems in the present case are described. No acne keloids were observed but atrophic scars that may be due to Marfan syndrome.

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Introduction

Acne fulminans is a rare but very severe condition within the spectrum of acne disease. It is characterized by cutaneous and systemic symptoms. The skin involvement usually covers the back, chest, and face with highly inflammatory lesions, nodules, and cysts with secondary ulcerations developing but comedones and non-inflammatory cysts may be completely missing. (1) The patients suffer from polyarthritis and in particular periarthritis which raises differential diagnoses like psoriasis arthritis, SAPHO-syndrome, or chronic recurrent osteomyelitis. (2) Fever is a common symptom reaching up to 40[degrees]C. Leukocytosis, elevation of blood sedimentation rate and C-reactive protein, proteinuria, liver and spleen enlargement and sterile bone lesions also have been observed. (3,4)

Acne fulminans, like any other type of acne, may also be influenced in the clinical presentation and course by coexistent disease. Here, we report a case of Marfan syndrome complicated by relapsing acne fulminans. The association has yet not been described in the available literature.

Case Report

A 12-year-old boy was referred to our department because of extensive suppurative ulcerations and hypergranulations on the chest and back, multiple inflammatory cysts in the aforementioned areas and on the face. In his medical history, a Marfan syndrome was confirmed (Figure 1). His mother also suffered from Marfan syndrome. The boy suffered from severe…