Management: A treatment and a trigger
The treatment of acne fulminans consists of supportive care and systemic steroids that are gradually reduced over weeks or months, according to the patient’s response. Interestingly, isotretinoin—a trigger for acne fulminans—is also very effective in its treatment.5,7
Outcome: Partial, gradual resolution
Isotretinoin stopped, prednisone started. In this patient’s case, we stopped the isotretinoin and treated him with prednisone, with an initial dose of 40 mg/day. His muscle pain improved.
Dosage tapered. Several attempts to reduce his dosage, however, resulted in a recurrence of pain. Gradual tapering of the steroidal treatment was achieved after 3 months.
Gradual improvement. The acne lesions resolved partially, and gradually, during several months of follow-up.
CORRESPONDENCE
Marcelo H. Grunwald, MD Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel E-mail: Marcello@bgu.ac.il