A CLINICAL CASE OF ACNE FULMINANS INDUCED BY ISOTRETINOIN THERAPY
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Abstract
A clinical case of isotretinoin-induced acne fulminans with systemic symptoms (IIAF-SS) in a 19-year-old patient is presented. The clinical presentation, dynamics of laboratory findings, and a step-by-step management strategy are described, including temporary withdrawal of retinoids, monotherapy with systemic glucocorticosteroids, and an attempt to reintroduce isotretinoin. It is shown that in patients with high immunological reactivity the standard reintroduction scheme may provoke a recurrence of the systemic inflammatory reaction, which justifies a personalised approach. The proposed ultra-slow descending withdrawal regimen of prednisolone allowed stable clinical and laboratory remission for 3.5 years to be achieved. The data obtained are of practical importance for the optimisation of therapy for severe forms of acne.
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