A 22-year-old male with severe nodulotubercular acne develops tender lymphadenopathy, fever, and arthralgia in addition to his acne lesions. He also has palmoplantar keratoderma. The most likely diagnosis is:
- A Acne conglobata with secondary septicaemia
- B PAPA syndrome (pyogenic arthritis, pyoderma gangrenosum, acne)
- C Acne fulminans ✓
- D SAPHO syndrome
Explanation
Acne fulminans is a rare, severe form of acne with sudden onset of painful, haemorrhagic, ulcerative nodules, preceded or accompanied by systemic features — fever, weight loss, leucocytosis, polyarthralgia/arthritis, and occasionally osteolytic bone lesions. It primarily affects teenage males and may be triggered by isotretinoin initiation. Treatment requires corticosteroids first to control systemic inflammation before adding isotretinoin. PAPA syndrome (PSTPIP1 mutation) is a rare autoinflammatory syndrome. SAPHO involves synovitis-acne-pustulosis-hyperostosis-osteitis.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.