Neutrophilic sebaceous adenitis responsive to oral isotretinoin

Persistent Malar Erythema With Atrophy in a Young Woman

“…The term neutrophilic sebaceous adenitis was first coined in 1997 by Renfro et al, who discovered unique sebaceous gland histopathologic characeristics of an erythematous eruption on the face of a male patient. Since then, similar presentations of NSA have been described in the literature only 8 times, including 6 reports in men and 2 in women …”

“…Since then, similar presentations of NSA have been described in the literature only 8 times, including 6 reports in men and 2 in women. [2][3][4][5][6][7][8] The erythematous, indurated plaques classically have annular, elevated borders without secondary changes or central clearing. The lesions are typically asymptomatic.…”

“…4,6 An association with demodex infection was suspected in 2 cases; however, the burden of these tiny mites histologically was not great enough to diagnose demodicosis. 5,8 More recently, reports of genital NSA have been discovered in women, which are clinically differentiated from cases of facial NSA, being hormone responsive and symptomatically painful. 9,10 Although its clinical picture is elusive, the histological hallmark of NSA is exclusive inflammation of the sebaceous glands with sparing of the remainder of the hair follicle.…”

Sebaceous adenitis in a man with autoimmune background

“…Concerning the etiopathogenesis of SA in humans, there are three main hypothesis: (1) photodermatosis as two cases were triggered by sun exposure [4][5][6]; (2) hypersensitivity to Demodex as two cases presented scarce Demodex on biopsy [3,7,8]; (3) toxicoderma, with analogy to neutrophilic eccrine hidradenitis [1,9].…”

“…Cyclosporine has been successfully used for the treatment of veterinary SA in dogs [11] and there are also some reports of successful treatment with retinoids. In humans, SA has mainly been treated with oral and topical corticoids and there is one case successfully treated with isotretinoin [7].…”