Therapy of severe acne: treatment results of five years at the Department of Dermatology and Allergology, University of Szeged

Acne conglobata and acne fulminans are rare, but very severe types of acne disease. These serious inflammatory skin disorders usually affect the adolescent and the young adult population. The early introduction of the efficient therapy is pivotal in order to prevent the development of severe scar formation. A retrospective study was performed between 2017 and 2021 in the Paediatric Outpatient Clinic of the Department of Dermatology and Allergology, University of Szeged. Demographic (age and gender) and clinical data (severity and extension of acne, duration of the inflammatory lesions, types of local and systemic therapies, duration of medical therapies and comorbidities) of the patients with acne conclobata or acne fuminans were analysed. Acne conglobata was diagnosed in 67, and acne fulminans in 2 patients during the study period. The mean age of the patients was 15,7 years, with a male predominance. Systemic therapy was introduced in 84% of the adolescents (n=58); 55 patients (80%) received isotretinoin therapy, oral corticosteroid treatment was necessary in 14 subjects (20%). Patients have received systemic treatment for 16 months on average; duration of corticosteroid therapy was 10,6 weeks and the period of isotretinoin therapy was 11,6 months on average. Follow-up visits were performed in every 2-3 weeks at the beginning of the therapy, and in every month during maintenance treatment. In acne conglobata and acne fulminans recommended treatment is oral isotretinoin often combined initially with oral corticosteroids. In more severe cases exacerbation of inflammatory symptoms can be observed after completion of retinoid therapy, and in these patients duration of treatment takes usually longer. Colitis ulcerosa and obesity can be associated with more severe forms of acne conglobata.