(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: The patient, an 18-year-old girl, was admitted to our hospital because of poor rest and insomnia overnight, which led to the rapid appearance of nodules and plaques on the facial area, both sides of the cheeks, and purulent changes with an uneven surface. Through clinical manifestations, blood tests and other tests, the comprehensive judgment was that it was violent acne. After treatment with prednisone acetate tablets + isotretinoin soft capsules and adjustment of diet and rest habits, the red purulent changes on the skin surface gradually subsided and the inflammatory infection improved significantly.
Basic information】Female, 18 years old
Disease Type】Burgeoning acne
Hospital】Harbin Hospital of Traditional Chinese Medicine
Date of consultation】March 2022
Treatment plan】Oral medication (prednisone acetate tablets, isotretinoin soft capsules)
Treatment period】30 days of home medication
Effectiveness】Red purulent changes on the skin surface gradually subsided, and the inflammatory infection improved significantly
I. Initial consultation
Patient’s description: Due to poor rest and lack of sleep, a large number of red inflammatory papules appeared on both sides of the cheeks overnight 3 days ago, accompanied by pain on pressure. On examination, there were obvious red inflammatory papules on both sides of the cheeks, nodules and plaques in the middle of the papules, and obvious white pustules in some parts due to suppuration, with uneven surface skin and some mild ulcerative changes. After communicating with the patient, the patient agreed to undergo a preliminary blood test, which showed an increase in white blood cell values, consistent with the characteristics of fulminant acne.
II. Treatment process
After communicating with the patient, we finalized the treatment plan and chose to take oral prednisone acetate tablets together with isotretinoin soft capsules for treatment. Prednisone acetate tablets are glucocorticoids with anti-inflammatory, anti-allergic and immunosuppressive effects. Oral prednisone acetate tablets are given for the first 4 weeks to effectively relieve the intense inflammatory response triggered by the initial stage of the disease. After that, the addition of isotretinoin soft capsules can promote epidermal differentiation and inhibit sebum metabolism to a certain extent, so that the symptoms of violent acne can be improved. After taking the medication, the patient understood how to use it and nodded that he would follow my medical advice on regular medication after going home, instructing the patient to take the medication on time and follow up regularly.
III. Treatment effect
After 40 days of medication, I made a telephone call to the patient to understand his condition and recovery. The patient said that after 4 weeks of application of prednisone acetate tablets, the inflammatory reaction on the local skin surface was significantly controlled, the nodules and plaques on the skin surface were significantly reduced, and the septic changes were mildly improved. After taking isotretinoin soft capsule for 2 weeks, although the skin surface had obvious side effects of dryness and peeling, the red patches on both sides of the cheeks had subsided significantly, and the pain disappeared after pressure, and the inflammatory infection had improved significantly. The patient was instructed to continue the medication and to follow up at any time.
(Comparison before and after treatment)
IV. Notes
I am very pleased that after active treatment, the patient’s symptoms have improved significantly. Burgeoning acne itself is related to both work and rest and diet. Patients were told to reduce late nights and avoid spicy and irritating foods and sweets to avoid aggravation of burgeoning acne symptoms. When choosing to use Prednisone Acetate Tablets, it is important to use them according to medical advice and not to take too much to avoid any effects on the body. Because isotretinoin soft capsules can cause side effects such as dry skin and dry eyes after taking them, continue to take them if the symptoms are not severe, and if the symptoms are more important follow up at any time to determine if you need to stop using the medication under the guidance of your doctor.
V. Personal insights
1. Fulminant acne itself is an extremely rare form of cystic acne that occurs in teenage boys and is also seen in girls.
2, the treatment of violaceous acne is mainly based on glucocorticoids, and isotretinoin soft capsules can be chosen for consolidation treatment at a later stage.
3. If patients experience fever and joint pain during treatment, they can take indomethacin capsules orally as appropriate, and the symptoms can be improved after taking them according to the doctor’s instructions.
4. Fulminant acne appears rapidly and the treatment period is relatively long, so it is important to have enough patience.