A b s t r a c tThe authors are presenting a rare case of recurrent acne fulminans (AF) in man with Crohn's disease (CD). First attak of AF as associated disorder was observed at the age of 21 with positivity rheumatoid factor (28.0 U/ml), Creactive protein (86.7 m/l), ANA (1:160), p-ANCA (1:40) and 82 erythrocyte sedimentation rate/1 hour. The second attak of AF was observed after the 4th infliximab (5mg/kg) administration, with azathioprine (100mg/day), with positivity Epstein-Barr (EBV Real Time PCR -1835 copies/ml). The effect of AF therapy was observed after methylprednisolone (0.5-1.0mg/kg/day) with isotretinoin (0.2-1.0mg/kg/day) administration, with continual infliximab administration.
The author is presenting the case of a 23-year-old female patient with a severe form of acne conglobata, with the first symptoms of the disease occurring as far back as the prepubertal age. In the past year the disease has combined with hidradenitis suppurativa (to be referred to henceforth as "HS"), Hurley stage I, in the axillae and both sides of the inguinal region, with a family history of acne conglobata (both her mother and brother were affected). Further examinations ruled out inflammatory bowel disease because of a lack of further associated symptoms, except for sideropenic anaemia (lesser form) and lower serum values of vitamin D. Up until now the disease has been resistant to treatment, including the long-term treatment of methylprednisolone in combination with isotretinoid as well as dapsone and antibiotics.
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