Recalcitrant acne vulgaris secondary to a dental abscess

This case report describes a middle-aged man with acne that was recalcitran t to numerous medications, including three courses of isotretinoin. His con dition cleared after an infected tooth was removed and recurred when anothe r tooth became carious. Acne vulgaris is associated with several immunologi c responses including the production of antibodies against Propionibacteriu m acnes, the gram-positive bacteria found in acne lesions. We believe that the presence of our patient's dental infections provoked a follicular infla mmatory response resulting in his recalcitrant acne.