Acne medicamentosa - Altmeyers Encyclopedia

Synonym(s)

Drug exanthema acneiformes; drug-induced acne

Definition
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Term for drug-induced, acne-like eruptions, but also for pre-existing acne aggravated by medication.

Etiopathogenesis
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Causative are especially the following drugs: glucocorticoids (steroid acne), barbiturates, INH, vitamin _B6, vitamin _B12,bromine- or chlorine-containing drugs(bromine acne, chlorine acne), blockers of the epidermal growth factor receptor ( EGF receptor; oncologics for the therapy of colorectal carcinoma; see also exanthem, acneiformes) cf. table 1.

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Dermatology

Exanthema, acneiformes

Predominantly drug-induced skin symptoms with acne-like efflorescences, but without comedones. S.a. Acne me...

Clinical features
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Usually monomorphic image with inflammatory follicular papules in the area of the seborrheic zones. No formation of comedones.

Differential diagnosis
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Demarcation from Acne vulgaris, see Table 2.

Therapy
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As far as possible, discontinuation or conversion of the triggering medication. External, possibly also systemic therapy, see below acne vulgaris.

Tables
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Acne provoking drugs

Trigger/Substance group	Examples
Steroids	Glucocorticoids, androgens, oral contraceptives
Antiepileptic drugs	trimethadione, diphenylhydantoin and other hydantoin derivatives
Antimalarials	quinine
Antabus	Disulfiram
Tuberculostatics	INH, ethionamide, rifampicin
Halides	Iodine and bromine compounds
Antidepressants	Lithium
PUVA	Psoralen (Methoxsalen) and UVA
Painkillers	Phenobarbiturates
Antibiotics	tetracyclines, streptomycin
Immunosuppressive drugs	Ciclosporin A
Thyrostatic agents	thiourea, thiouracil
Vitamins	_B1, B6, B12
Biologicals (EGF-R blockers)	gefitinib, cetuximab

Drug-induced acneiform eruptions (differential diagnostic criteria)

	Acne	Drug-induced acneiform eruptions
Start	Mostly puberty	Mostly adulthood
Localization	Seborrheic zones	Seborrheic zones
Etiology	Androgens, follicular keratoses, sebum, propionibacteria, genetically determined	Drugs
Efflorescences, primary	Komedo	papule, papulopustule
Efflorescences, secondary	papules, papulopustule, nodules, cysts, fistulations	Comedones
Scarring	Pronounced in inflammatory form	Mostly no scarring
Forecast	Chronic course	Short term, healing after avoiding the cause