title: Hepatitis B, interferon, and acne fulminans in a young girl.
abstract: Acne fulminans (AF) is a very rare severe form of acne seen in young males, characterized by a sudden and explosive onset of hemorrhagic pustules and ulceration on the trunk, systemic features in the form of fever, polyarthropathy, malaise, erythema nodosum and painful osteolytic bone involvement with leukocytosis, and an elevated erythrocyte sedimentation rate. Conventional treatment of AF includes corticosteroids or immunosuppressive agents for the initial phase followed by isotretinoin. Active hepatitis B infection with a high viral load precludes the administration of any immunosuppressive drugs. We present the case of an 18-year-old girl with a history of occasional acne who presented with AF of sudden onset following administration of interferon-alpha-2a for her recently detected hepatitis B infection. Management of hepatitis B was withheld in view of her general condition. The patient was managed with low dose isotretinoin with subsidence of lesions. AF in a young female precipitated by interferon and its management with isotretinoin in the presence of active hepatitis B infection make the case unique.
authors.affiliation: Department of Dermatology, Army College of Medical Sciences, Base Hospital, Delhi, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Arora
authors.affiliation: Department of Pathology, Army College of Medical Sciences, Base Hospital, Delhi, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Malik
authors.affiliation: Department of Gastroenterology, Army College of Medical Sciences, Base Hospital, Delhi, India.
authors.forename: Dharmendra
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Department of Dermatology, Army College of Medical Sciences, Base Hospital, Delhi, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Sodhi
keywords: Acne fulminans; hepatitis B; interferon