title: Successful acne management in Apert syndrome twins.
abstract: Apert syndrome, or acrocephalosyndactyly, is characterized by craniosynostosis and early epiphyseal closure resulting in various deformities of the skull, hands, and feet. Typically a sporadic condition, autosomal dominant inheritance with complete penetrance has been known to occur. Most adolescents with the disorder are prone to the development of severe pustular facial and truncal acne, with extension to the upper arms and forearm. We report twin brothers with Apert syndrome who, after 2 years of standard management by their pediatrician, were referred for management of complicated acne. In our patients there were a constellation of findings consistent with the disorder and, of importance to this report, significant dermatological manifestations. On presentation, each brother was found to have acne vulgaris of a different stage. Our patients were refractory to conventional treatment for acne but one required and had a significant response to isotretinoin. The risk/benefit ratio in treating acne lesions with isotretinoin in a teenager with Apert syndrome is reviewed.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, Division of Pediatric Dermatology, University of Miami School of Medicine, Miami, Florida 33101, USA. lbenjamin@med.miami.edu
authors.forename: Latanya T
authors.initials: LT
authors.lastname: Benjamin
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Trowers
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Schachner
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D000168:Acrocephalosyndactylia / Q000150:complications / Q000175:diagnosis*; D000293:Adolescent; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use*; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D013752:Tetracycline / Q000627:therapeutic use*; D016896:Treatment Outcome; D014427:Twins
chemical_list: D015474:Isotretinoin; D013752:Tetracycline