ACNE FULMINANS AND ERYTHEMA-NODOSUM DURING ISOTRETINOIN THERAPY RESPONDING TO DAPSONE

Acne vulgaris is very common, 85% of teenagers being affected at any o ne time. In most cases, the disease is mild and patients do not presen t to the dermatologist. Most are instead treated with over-the-counter products and conventional treatment such as peeling agents or topical and systemic antibiotics. Isotretinoin has revolutionized the treatme nt of severe acne unresponsive to oral antibiotics. Explosive and very severe acne such as pyoderma faciale, acne conglobata and acne fulmin ans are rare, the features that distinguish acne fulminans from the ot her conditions being systemic upset. with fever, joint pain, malaise a nd leucocytosis,(1-3) while there have been two reports of the conditi on associated with erythema nodosum.(4,5) The recommended treatment fo r acne fulminans sum. is a combination of oral steroids and systemic a ntibiotics, isotretinoin probably not being the treatment of choice.(6 ) We now report. a patient who developed acne fulminans and erythema n odosum within 3 weeks of starting isotretinoin and then responded to d apsone without Oral steroids.