Acne Conglobata Associated With Ulcerative Colitis, Treated With Corticosteroids and Mesalazin : e-poster

Abstract

Introduction Acne is one of the most common dermatological problems that affect pilosebaceus unit. Acne can be provoked or worsen by particular drugs (corticosteroids, halogens, cyclosporin and others) and diseases (inflammatory bowel disease (IBD), various endocrine disorders with excess of androgens). Case report A 32–year old Caucasian woman had been affected by ulcerative colitis for the past year. The treatment of ulcerative colitis was started with prednisolon 50mg/day dose for 4 months. After 2 months of prednisolon therapy additionally the mesalazin therapy with 4 g/day dose was started. Overall the mesalazin therapy was continued 8 months. The patient developed acne after 6 months of systemic treatment. Upon physical examination on the face she had numerous open and closed comedones, papules, pustules, deep inflammatory nodules, nodes and some cysts. There were no efflorescence on the back and chest. Initial therapy of acne was composed of oral doxycyclin 200 mg/day for 14 days, local treatment with adapalen, alfa and beta hydroxy acids. After 14 days of treatment there were no significant changes. Despite our concern about the potential adverse effects of systemic retinoids on underlying IBD, systemic treatment with doxycyclin was discontinued and oral isotretinoin therapy with 30 mg/day doses was started. After 4 months of acne treatment, the mesalazin therapy was discontinued. Overall the isotretinoin therapy was continued 6 months (the cumulative dose – 80 mg/kg), the number of noninflammatory and inflammatory lesions was significantly reduced and some postinflammatory macules and scars were formed. Comments According literature mesalazin can cause acne, but to our knowledge there are no published clinical studies or case reports. In summary, the acne conglobata in this case could be caused by ulcerative colitis and systemic treatment with mesalazin and corticosteroids.[...].