ECTRODACTYLY, SOFT-TISSUE SYNDACTYLY, AND NODULOCYSTIC ACNE - COINCIDENCE OR ASSOCIATION

We report severe nodulocystic acne in a 21-year-old man associated wit h ectrodactyly of the right foot and soft-tissue syndactyly of the thi rd and fourth left fingers, and the first to fourth left toes. His acn e was resistant to conventional topical (clindamycin phosphate, erythr omycin, tretinoin, peeling agents) and systemic (tetracycline, erythro mycin) antiacne medications. Moderate improvement was achieved with sy stemic isotretinoin. Apart from presenting this case, we imply the dis parity of the clinical characteristics of our case and those of Apert syndrome, a rare congenital condition with craniofacial anomalies, sym metric syndactyly of the digits, and acneiform eruption. We discuss th e possible explanation for the association of acne lesions and bone de formities based on recent reports of mutations of fibroblast growth fa ctor receptor 2 in the great majority of patients with this syndrome, as well as current experimental data on the involvement of the keratin ocyte growth factor in the process of hair follicle growth, developmen t, and differentiation.