A Case Report of Concurrent Acne-Related Occurrence Complications: Telangiectasia, Post-Inflammatory Erythema, Post-Inflammatory Hyperpigmentation, and Atrophic and Hypertrophic Scars
Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifestations of mandibular acne did not improve. At the time of initial examination, telangiectasia (TE), post-inflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), atrophic scars (ASs), and a hypertrophic scar (HS) with induration were observed on the right neck. We diagnosed this as an acne vulgaris complication. HS lesions were topically treated by injecting triamcinolone acetonide, and the patient was prescribed 8.1 g/day of oral Saireito (Japanese herb). Adapalene benzoyl peroxide gel and topical tacrolimus hydrate ointment were used to treat PIE and TE. Both HSs and PIE improved; however, TE and AS did not improve. Currently, the patient is under observation. We consider this to be a very rare concurrent occurrence of diverse complications of acne vulgaris, and present the following case study.
References
[1]
Kurokawa, I., Layton, A. and Ogawa, R. (2021) Updated Treatment for Acne: Targeted Therapy Based on Pathogenesis. Dermatologic Therapy, 11, 1129-1139. https://doi.org/10.1007/s13555-021-00552-6
[2]
Goodman, G.J. and Baron, J.A. (2006) Postacne Scarring: A Qualitative Global Scarring Grading System. Dermatologic Surgery, 32, 1458-1466. https://doi.org/10.1111/j.1524-4725.2006.32354.x
[3]
Park, K.Y., Ko, E.J., Seo, S.J. and Hong, C.K. (2014) Comparison of Fractional, Nonablative, 1550-nm Laser and 595-nm Pulsed Dye Laser for the Treatment of Facial Erythema Resulting from Acne: A Split-Face, Evaluator-Blinded, Randomized Pilot Study. Journal of Cosmetic and Laser Therapy, 16, 120-123. https://doi.org/10.3109/14764172.2013.854626
[4]
Kalantani, Y., Dadkhahfar, S. and Etesami, I. (2022) Post-Acne Erythema Treatment: A Systematic Review of the Literature. Journal of Cosmetic Dermatology, 21, 1379-1392. https://doi.org/10.1111/jocd.14804
[5]
Wu, X., Wang, X., Wu, X., et al. (2022) Intense Pulsed Light Therapy Improves Acne-Induced Post-Inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients. Dermatologic Therapy, 12, 1147-1156. https://doi.org/10.1007/s13555-022-00719-9
[6]
Kurokawa, I., Oiso, N. and Kawada, A. (2017) Adjuvant Alternative Treatment with Chemical Peeling and Subsequent Iontophoresis for Postinflammatory Hyperpigmentation, Erosion with Inflamed Red Papules and Non-Inflamed Atrophic Scars in Acne Vulgaris. The Journal of Dermatology, 44, 401-405. https://doi.org/10.1111/1346-8138.13634
[7]
Layton, A., Thiboutot, D. and Bettoli, V. (2004) Acne, Fast. Health Press, London.
[8]
Layton, A., Yip, J. and Cunliffe, W.J.A. (1994) Comparison of Intralesional Triamcinolone and Cryosurgery in the Treatment of Acne Keloids. British Journal of Dermatology, 130, 498-501. https://doi.org/10.1111/j.1365-2133.1994.tb03385.x
[9]
Jacob, C.I., Dover, J.S. and Kaminer, M.S. (2001) Acne Scarring: A Classification System and Review of Treatment Options. Journal of the American Academy of Dermatology, 45, 109-117. https://doi.org/10.1067/mjd.2001.113451
[10]
Tan, J., Bourdès, V., Bissonnette, R., et al. (2017) Prospective Study of Pathogenesis of Atrophic Acne Scars and Role of Macular Erythema. Journal of Drugs in Dermatology, 18, 567-573.
[11]
Jakhar, D. and Kaur, I. (2020) Topical 5% Tranexamic Acid for Acne Related Postinflammatory Erythema. JAAD Online, 82, e187-e188. https://doi.org/10.1016/j.jaad.2019.09.074
[12]
Innocenzi, D. and Proietti, I. (2010) Treatment Algorithm for Acne Scars. In: Tosti, A., et al., Eds., Acne Scars: Classification and Treatment, Informa Health, London, 110-123.
[13]
Lanoue, J. and Goldenberg, G. (2015) Acne Scarring: A Review of Cosmetic Therapies. Cutis, 95, 276-281.
[14]
Min, A., Park, A.Y., Yon, J.Y., Kwon, H.H. and Suh, D.H. (2016) Fractional Microneedling Radiofrequency Treatment for Acne-Related Post-Inflammatory Erythema. Acta Dermato-Venereologica, 96, 87-91. https://doi.org/10.2340/00015555-2164
[15]
Bamford, J.T., Elliott, B.A. and Haller, I.V. (2004) Tacrolimus Effect in Rosacea. Journal of the American Academy of Dermatology, 50, 107-108. https://doi.org/10.1016/S0190-9622(03)02157-1
[16]
Wang, Y., Yang, S., Wu, L. and Tu, P. (2009) Topical Tacrolimus Suppresses the Expression of Vascular Endothelial Growth Factor and Insulin-Like Growth Factor-1 in Late Anagen. Clinical and Experimental Dermatology, 34, e937-940. https://doi.org/10.1111/j.1365-2230.2009.03339.x
[17]
Mhatre, M., Sharma, A. and Agrawal, S. (2022) Topical Tacrolimus for Acne-Related Macular Erythema to Prevent Atrophic Scarring. Journal of the American Academy of Dermatology, 86, e253-e254. https://doi.org/10.1016/j.jaad.2020.06.077
