Acne Keloidalis

Diagnosis: Acne Keloidalis

Case submitted by Murtuza Bandukwala to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Murtuza Bandukwala. Originally posted July 1, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Rosacea • Perioral dermatitis • Folliculitis (bacterial, fungal/pityrosporum) • Demodex folliculorum infestation • Drug-induced acneiform eruption • Keratosis pilaris

Key Learnings

• Multifactorial pathogenesis: follicular hyperkeratinization, excess sebum, C. acnes, inflammation • Isotretinoin is the only therapy that targets all four pathogenic factors • Post-inflammatory hyperpigmentation more common and persistent in skin of color • Avoid unnecessary antibiotics — limit courses to 3-4 months and combine with benzoyl peroxide

Tags: acne, keloidalis, murtuza bandukwala