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J Cosmet Med 2022; 6(2): 99-102

Published online December 31, 2022

https://doi.org/10.25056/JCM.2022.6.2.99

Treatment of acne fulminans with intense pulsed light: a case report

Cheuk Hung Lee, MBBS (HK), FHKAM (MED), FHKCP, MScPD (Cardiff), MRCP (UK), DPD (Wales), DipDerm (Glasgow), PGDipClinDerm (London), MRCP (London), GradDipDerm (NUS), DipMed (CUHK)1 , Kar Wai Alvin Lee, MBChB (CUHK), DCH (Sydney), Dip Derm (Glasgow), MScClinDerm (Cardiff), MScPD (Cardiff), DipMed (CUHK), DCH (Sydney)1 , Kwin Wah Chan, MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney)1 , Kar Wai Phoebe Lam, MBCHB (OTAGO), MRCS (EDIN), MSCPD (CARDIFF)2

1Ever Keen Medical Centre, Hong Kong
2Perfect Skin Solution, Hong Kong

Correspondence to :
Kar Wai Alvin Lee
E-mail: alvin429@yahoo.com

Received: September 5, 2022; Revised: October 11, 2022; Accepted: October 17, 2022

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Acne fulminans is a severe form of acne that has a considerable psychosocial impact. Acne scarring is a potential complication of this condition. The treatment of acne fulminans includes conventional topical antibiotics, systemic antibiotics, hormonal therapy, isotretinoin, and light therapy. Intense pulsed light can have marked effects on acne fulminans. We aimed to describe the treatment of acne fulminans with intense pulsed light. This article is a case report together with a literature review to demonstrate how intense pulsed light can be used to treat acne fulminans. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on acne fulminans. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for acne fulminans. Our case report revealed that intense pulse light using multiple filters at certain energy levels can effectively treat acne fulminans. Current evidence suggests that ablative CO2 and Er:YAG lasers provide the best curative effect on acne scars on all skin types. Potential complications with intense pulsed light include pain, burns, and post-inflammatory hyperpigmentation. Intense pulsed light is an effective treatment modality for acne fulminans. However, more cases of acne fulminans treated with intense pulsed light need to be documented in order to affirm intense pulsed light as one of the best options for treating this severe form of acne.

Keywords: acne vulgaris, anti-bacterial agents, drug resistance, intense pulsed light therapy, phototherapy

Fig. 1.Patient’s right face before the first session of intense pulsed light treatment.
  1. Zaba R, Schwartz R, Jarmuda S, Czarnecka-Operacz M, Silny W. Acne fulminans: explosive systemic form of acne. J Eur Acad Dermatol Venereol 2011;25:501-7.
    Pubmed CrossRef
  2. Seukeran DC, Cunliffe WJ. The treatment of acne fulminans: a review of 25 cases. Br J Dermatol 1999;141:307-9.
    Pubmed CrossRef
  3. Greywal T, Zaenglein AL, Baldwin HE, Bhatia N, Chernoff KA, Del Rosso JQ, et al. Evidence-based recommendations for the management of acne fulminans and its variants. J Am Acad Dermatol 2017;77:109-17.
    Pubmed CrossRef
  4. Babilas P, Schreml S, Szeimies RM, Landthaler M. Intense pulsed light (IPL): a review. Lasers Surg Med 2010;42:93-104.
    Pubmed CrossRef
  5. Bojar RA, Holland KT. Acne and propionibacterium acnes. Clin Dermatol 2004;22:375-9.
    Pubmed CrossRef
  6. Chua SH, Ang P, Khoo LS, Goh CL. Nonablative 1450-nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective clinical study. Dermatol Surg 2004;30:1287-91.
    Pubmed CrossRef
  7. Moses HL, Coffey RJ Jr, Leof EB, Lyons RM, Keski-Oja J. Transforming growth factor beta regulation of cell proliferation. J Cell Physiol Suppl 1987;Suppl 5:1-7.
    Pubmed CrossRef
  8. Yu W, Naim JO, Lanzafame RJ. Effects of photostimulation on wound healing in diabetic mice. Lasers Surg Med 1997;20:56-63.
    CrossRef
  9. Young S, Bolton P, Dyson M, Harvey W, Diamantopoulos C. Macrophage responsiveness to light therapy. Lasers Surg Med 1989;9:497-505.
    Pubmed CrossRef
  10. Negishi K, Wakamatsu S, Kushikata N, Tezuka Y, Kotani Y, Shiba K. Full-face photorejuvenation of photodamaged skin by intense pulsed light with integrated contact cooling: initial experiences in Asian patients. Lasers Surg Med 2002;30:298-305.
    Pubmed CrossRef
  11. Weiss RA, Weiss MA, Beasley KL. Rejuvenation of photoaged skin: 5 years results with intense pulsed light of the face, neck, and chest. Dermatol Surg 2002;28:1115-9.
    Pubmed CrossRef
  12. Patidar MV, Deshmukh AR, Khedkar MY. Efficacy of intense pulsed light therapy in the treatment of facial acne vulgaris: comparison of two different fluences. Indian J Dermatol 2016;61:545-9.
    Pubmed KoreaMed CrossRef

Article

Case Report

J Cosmet Med 2022; 6(2): 99-102

Published online December 31, 2022 https://doi.org/10.25056/JCM.2022.6.2.99

Copyright © Korean Society of Korean Cosmetic Surgery.

Treatment of acne fulminans with intense pulsed light: a case report

Cheuk Hung Lee, MBBS (HK), FHKAM (MED), FHKCP, MScPD (Cardiff), MRCP (UK), DPD (Wales), DipDerm (Glasgow), PGDipClinDerm (London), MRCP (London), GradDipDerm (NUS), DipMed (CUHK)1 , Kar Wai Alvin Lee, MBChB (CUHK), DCH (Sydney), Dip Derm (Glasgow), MScClinDerm (Cardiff), MScPD (Cardiff), DipMed (CUHK), DCH (Sydney)1 , Kwin Wah Chan, MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney)1 , Kar Wai Phoebe Lam, MBCHB (OTAGO), MRCS (EDIN), MSCPD (CARDIFF)2

1Ever Keen Medical Centre, Hong Kong
2Perfect Skin Solution, Hong Kong

Correspondence to:Kar Wai Alvin Lee
E-mail: alvin429@yahoo.com

Received: September 5, 2022; Revised: October 11, 2022; Accepted: October 17, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acne fulminans is a severe form of acne that has a considerable psychosocial impact. Acne scarring is a potential complication of this condition. The treatment of acne fulminans includes conventional topical antibiotics, systemic antibiotics, hormonal therapy, isotretinoin, and light therapy. Intense pulsed light can have marked effects on acne fulminans. We aimed to describe the treatment of acne fulminans with intense pulsed light. This article is a case report together with a literature review to demonstrate how intense pulsed light can be used to treat acne fulminans. Pre-treatment and post-treatment clinical photographs are provided to show the effects of intense pulsed light therapy on acne fulminans. No comparisons were made with the other treatment modalities; nevertheless, this study provides an alternative treatment option for acne fulminans. Our case report revealed that intense pulse light using multiple filters at certain energy levels can effectively treat acne fulminans. Current evidence suggests that ablative CO2 and Er:YAG lasers provide the best curative effect on acne scars on all skin types. Potential complications with intense pulsed light include pain, burns, and post-inflammatory hyperpigmentation. Intense pulsed light is an effective treatment modality for acne fulminans. However, more cases of acne fulminans treated with intense pulsed light need to be documented in order to affirm intense pulsed light as one of the best options for treating this severe form of acne.

Keywords: acne vulgaris, anti-bacterial agents, drug resistance, intense pulsed light therapy, phototherapy

Fig 1.

Figure 1.Patient’s right face before the first session of intense pulsed light treatment.
Journal of Cosmetic Medicine 2022; 6: 99-102https://doi.org/10.25056/JCM.2022.6.2.99

References

  1. Zaba R, Schwartz R, Jarmuda S, Czarnecka-Operacz M, Silny W. Acne fulminans: explosive systemic form of acne. J Eur Acad Dermatol Venereol 2011;25:501-7.
    Pubmed CrossRef
  2. Seukeran DC, Cunliffe WJ. The treatment of acne fulminans: a review of 25 cases. Br J Dermatol 1999;141:307-9.
    Pubmed CrossRef
  3. Greywal T, Zaenglein AL, Baldwin HE, Bhatia N, Chernoff KA, Del Rosso JQ, et al. Evidence-based recommendations for the management of acne fulminans and its variants. J Am Acad Dermatol 2017;77:109-17.
    Pubmed CrossRef
  4. Babilas P, Schreml S, Szeimies RM, Landthaler M. Intense pulsed light (IPL): a review. Lasers Surg Med 2010;42:93-104.
    Pubmed CrossRef
  5. Bojar RA, Holland KT. Acne and propionibacterium acnes. Clin Dermatol 2004;22:375-9.
    Pubmed CrossRef
  6. Chua SH, Ang P, Khoo LS, Goh CL. Nonablative 1450-nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective clinical study. Dermatol Surg 2004;30:1287-91.
    Pubmed CrossRef
  7. Moses HL, Coffey RJ Jr, Leof EB, Lyons RM, Keski-Oja J. Transforming growth factor beta regulation of cell proliferation. J Cell Physiol Suppl 1987;Suppl 5:1-7.
    Pubmed CrossRef
  8. Yu W, Naim JO, Lanzafame RJ. Effects of photostimulation on wound healing in diabetic mice. Lasers Surg Med 1997;20:56-63.
    CrossRef
  9. Young S, Bolton P, Dyson M, Harvey W, Diamantopoulos C. Macrophage responsiveness to light therapy. Lasers Surg Med 1989;9:497-505.
    Pubmed CrossRef
  10. Negishi K, Wakamatsu S, Kushikata N, Tezuka Y, Kotani Y, Shiba K. Full-face photorejuvenation of photodamaged skin by intense pulsed light with integrated contact cooling: initial experiences in Asian patients. Lasers Surg Med 2002;30:298-305.
    Pubmed CrossRef
  11. Weiss RA, Weiss MA, Beasley KL. Rejuvenation of photoaged skin: 5 years results with intense pulsed light of the face, neck, and chest. Dermatol Surg 2002;28:1115-9.
    Pubmed CrossRef
  12. Patidar MV, Deshmukh AR, Khedkar MY. Efficacy of intense pulsed light therapy in the treatment of facial acne vulgaris: comparison of two different fluences. Indian J Dermatol 2016;61:545-9.
    Pubmed KoreaMed CrossRef

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