Acne fulminans

master's thesis

• Author: Patricia Videc
• Mentor: Zrinka Bukvić Mokos (mentor)
• Committee member: Suzana Ljubojević Hadžavdić (predsjednik povjerenstva)
• Committee member: Krešimir Kostović (član povjerenstva)
• Committee member: Zrinka Bukvić Mokos (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Dermatology); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology

Abstract

Acne fulminans rijedak je i najteži oblik akne koji se najčešće javlja u adolescenata muškog spola. Etiopatogeneza je i danas nedovoljno razjašnjena, ali poznato je nekoliko čimbenika koji bi mogli biti ključni u nastanku bolesti. Smatra se da bolest može nastati zbog reakcije preosjetljivosti tipa III na antigene Propionibacterium acnes. Povišene razine testosterona i anaboličkih steroida, liječenje izotretinoinom, infektivne bolesti kao što su ospice te genetska predispozicija također imaju važnu ulogu u etiopatogenezi. Ova destruktivna bolest manifestira se naglim nastankom kožnih i sustavnih simptoma. Karakterizirana je pojavom brojnih, upalnih, bolnih nodusa koji kasnije egzulceriraju, a pojavljuju se na koži lica, leđa i prsiju. Sustavni simptomi i znakovi su vrućica, umor, mialgija i artralgija. Dijagnoza bolesti temelji se na kliničkoj slici te laboratorijskim i radiološkim nalazima. U liječenju bolesti primjenjuju se sustavni kortikosteroidi (0.5-1.0 mg/kg prednizolona na dan), a izotretinoin (0.5 mg/kg na dan) se uvodi četvrti tjedan nakon početka primjene kortikosteroida. Postoje i druge terapijske mogućnosti koje se mogu kombinirati s kortikosteroidima, a to su sulfoni, ciklosporin A i infliksimab. Preporuča se primjena lokalnih kompresa s otopinom ureje, a za opće simptome nesteroidni protuupalni lijekovi. Liječenje bolesti traje 3-5 mjeseci, a rana dijagnoza i liječenje vrlo su važni jer bolest ostavlja velike ožiljke koje je teško (a ponekad i nemoguće) izliječiti.

Abstract (english)

Acne fulminans is a rare and the most severe form of acne that usually affects male adolescents. The etiopathogenesis remains unclear, but several factors which might play a role in the onset of the disease are known. It is associated with type III hypersensitivity reaction to P.acnes antigens. High concentrations of testosterone and anabolic steroids, isotretinoin treatment, infectious diseases like measles and genetic predisposition could also be an important factor in etiopathogenesis. This destructive disease manifests itself with a sudden onset of skin and systemic symptoms. It is characterized by numerous inflammatory, painful nodules (which progress into ulcers) on the face, chest and back. Systemic signs and symptoms include fever, fatigue, myalgia and arthralgia. The diagnosis is based on clinical manifestations, laboratory tests and radiology examinations. The treatment of the disease consists of systemic corticosteroids (0.5-1.0 mg/kg prednisolone per day) and isotretinoin (0.5 mg/kg per day) which is given four weeks after corticosteroid use. Other treatment options to be combined with corticosteroids are sulfones, cyclosporin A and infliximab. Urea compresses may be used topically, whereas nonsteroidal antiinflammatory drugs are recommended for general symptoms. Treatment of the disease takes 3-5 months. Eearly diagnosis and treatment is very important because this disease leaves extensive scars that are difficult, sometimes impossible to treat.

• Keywords: acne fulminans; sustavni kortikosteroidi; izotretinoin
• Keywords (english): acne fulminans; systemic corticosteroids; isotretinoin
• Language: croatian
• URN:NBN: urn:nbn:hr:105:103007
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-03-16 08:47:01