Bromoderm L27.15

Rather rare acneiform drug reaction to bromine-containing drugs. Bromides and organic bromine compounds including bromourea derivatives such as Cabromal are now considered outdated sedative therapeutic principles; they were formerly used as sleeping pills, among other things. Danger of bromine intoxication (bromism), especially because of extremely long half-life (20 days) of bromide in the body! Recently, bromine-containing drugs have been used as cytostatics in myeloproliferative diseases (Pipobroman [Vercite]; approved in France for the treatment of polycythemia vera). Furthermore, bromine-containing antiepileptic drugs exist (potassium bromide Desitin); used e.g. in the context of anticonvulsive therapy in Dravet syndrome.

Notice!

• Acne vulgaris (acne typical distribution, wrong age, no comedones).
• Acne-form exanthema (largely identical clinic; however, the medical history of the bromide medication is missing; see etiology of acne-form exanthema).
• Acne-like syphilide (acne-like distributed clinical picture without comedones, no typical follicular relation, papules rather brown than red; serology!)
• Pyoderma faciale (acne conglobata-like, peracute to subacute clinical picture, especially in young women with pustules and deep abscesses on the face).
• Follicular pyoderma (numerous pustules, also follicular nodules, no comedones; smear with evidence of the pathogens; painful lymphadenitis)
• Tinea barbae (folliculitis and formation of furunculoid nodes. Diseased hair can be epilated painlessly. Native fungus detection possible; fungal culture positive).

1. Sobottka A et al (2008) Conglobulating indurated nodules and pustules in the face of a 55-year-old patient. Dermatologist 59: 734-736
2. Van der Meiren (1950) A case fo vegetative bromoderma. arch Belg Dermatol Syphiligr 6: 269-271