Tanya Greywal1, Andrea L Zaenglein2, Hilary E Baldwin3, Neal Bhatia4, Karen A Chernoff5, James Q Del Rosso6, Lawrence F Eichenfield7, Marc H Levin8, James J Leyden9, Diane M Thiboutot2, Guy F Webster10, Sheila Fallon Friedlander7. 1. University of California, San Diego, California; Rady Children's Hospital-San Diego, San Diego, California. Electronic address: tgreywal@gmail.com. 2. Pennsylvania State University, State College, Pennsylvania; Hershey Medical Center, Hershey, Pennsylvania. 3. State University of New York Downstate Medical Center, New York, New York. 4. Therapeutics Clinical Research, San Diego, California. 5. Cornell University, Ithaca, New York. 6. Touro University, Henderson, Nevada. 7. University of California, San Diego, California; Rady Children's Hospital-San Diego, San Diego, California. 8. University of California, San Francisco, California. 9. University of Pennsylvania, Philadelphia, Pennsylvania. 10. Thomas Jefferson University, Philadelphia, Pennsylvania.
Abstract
BACKGROUND: Acne fulminans (AF) is a severe variant of inflammatory acne. It typically manifests as an explosive worsening and ulceration of skin lesions, and can be associated with systemic symptoms. However, there is a paucity of evidence-based information and no clear guidelines concerning the classification and treatment of AF. OBJECTIVE: To better define the spectrum of AF and its variants, devise optimal therapeutic approaches, and identify areas of future research. METHODS: A panel of physicians with expertise in severe acne vulgaris was convened after a comprehensive literature review of severe acne variants. Priority topics were reviewed and presented by each panelist at a 5-hour conference. Following review of the audiotape and scribed notes from the conference, surveys were utilized to address points of controversy and to clarify consensus recommendations. RESULTS: Appropriate clinical case presentations and consensus survey questions were utilized to create final recommendations based on both the literature and the expert consensus. LIMITATIONS: Limited evidenced-based data and prospective studies in the literature concerning the treatment of AF is available. CONCLUSION: These guidelines better characterize AF and provide health care practitioners approaches to the classification, treatment, and prevention of AF and its variants.
BACKGROUND:Acne fulminans (AF) is a severe variant of inflammatory acne. It typically manifests as an explosive worsening and ulceration of skin lesions, and can be associated with systemic symptoms. However, there is a paucity of evidence-based information and no clear guidelines concerning the classification and treatment of AF. OBJECTIVE: To better define the spectrum of AF and its variants, devise optimal therapeutic approaches, and identify areas of future research. METHODS: A panel of physicians with expertise in severe acne vulgaris was convened after a comprehensive literature review of severe acne variants. Priority topics were reviewed and presented by each panelist at a 5-hour conference. Following review of the audiotape and scribed notes from the conference, surveys were utilized to address points of controversy and to clarify consensus recommendations. RESULTS: Appropriate clinical case presentations and consensus survey questions were utilized to create final recommendations based on both the literature and the expert consensus. LIMITATIONS: Limited evidenced-based data and prospective studies in the literature concerning the treatment of AF is available. CONCLUSION: These guidelines better characterize AF and provide health care practitioners approaches to the classification, treatment, and prevention of AF and its variants.