Acne medicamentosa L70.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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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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In particular, the following drugs may be responsible for this: 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), oncological drugs for the therapy of colorecatal carcinoma (see also Exanthem, akneiformes), see Table 1.

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

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020