Clinical case of acne inversa

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Abstract

Acne inversa is a rare skin disease characterized by recurrent nodules and abscesses that rupture with suppurative discharge and lead to sinus tracts and scarring. The disease is chronic and debilitating. In typical cases, it is diagnosed at late stages, when more aggressive therapeutic treatment is obligatory. There is not generally any accepted therapeutic algorithms, therefore, it is a difficult-to-manage disease, which determines the necessity for further study.

We present a clinical case of acne inversa with non-classical phenotypic features and the results of its treatment with systemic retinoids, and metformin. We also provide a review of the literature on the etiology, pathogenesis, and diagnosis of acne inversa.

Currently, there is no reliable algorithms of diagnostics and effective treatment for patients with acne inversa, which underlines the importance of further study of this disease.

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About the authors

Natalya P. Teplyuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: teplyukn@gmail.com
ORCID iD: 0000-0002-5800-4800

Dr. Sci. (Med.), Professor

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

Anna S. Pirogova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: annese@mail.ru
ORCID iD: 0000-0002-2246-1321

MD, Graduate Student

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

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2. Fig. 1. Patient G., 20 years old, with inverse acne. Rashes are located in the scalp, groin, inner thighs, perianal region: а ― follicular papules, pustules, erosion and foci of cicatricial atrophy; б ― fibrous cord of stony density without discharge, in the area of which hair growth is sparse; в ― in the perianal region, an opened draining abscess and the formation of a sinus course are visualized; г ― follicular papules and single pustules, foci of cicatricial atrophy and post-inflammatory hyperpigmentation.

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3. Fig. 2. The same patient. The histological picture of the scalp biopsy specimen: а ― hyperplasia of the sebaceous glands; pronounced lymphoid infiltration around individual sebaceous hair units; б ― infundibular hyperkeratosis, hyperplasia of follicular epithelium.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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