Disfiguring draining sinus tracts in a female acne patient

A 17-year-old girl with a 9-month history of papulopustular acne developed disfiguring, highly inflammatory, fluctuant nodules in both nasolabial fold s within 2 months. Periodically she experienced discharge of pus and blood from these lesions. A diagnosis of disfiguring draining sinus tracts associ ated with acne vulgaris was made. The therapeutic regimen included intrales ional corticosteroid injection, systemic corticosteroids along with a macro lide antibiotic, and systemic isotretinoin to reduce the inflammatory proce ss. Outcome was favorable, with no recurrences during the following 10 mont hs. Draining sinus is a malevolent lesion usually seen in severe forms of a cne such as acne conglobata, acne fulminans, and acne inverse. Treatment is difficult and often unsatisfactory. In many cases, excision of the lesion is necessary to provide a permanent cure.