acneiform drug eruption depakote

J Clin Oncol 2010 May 20; 28 (15 Suppl. Acne vulgaris is a chronic skin disease that develops as a result of inflammation of the pilosebaceous unit and its clinical course is accompanied by comedones, papules, pustules, and nodules. This type of drug eruption has an abrupt onset and is often associated with various medications (Table 54.1).

References; Physical Examination. Infections which are known to cause acneiform eruptions include secondary syphilis, mycotic infections, cutaneous coccidioidomycosis, and Sporothrix schenckii.Prolonged and increased excretion of causative substances might irritate the follicular epithelium and produce an inflammatory reaction.Acneiform eruptions can also be seen in conditions like nevus comedonicus, eruptive hair cysts, and tuberous sclerosis.This acne can occur due to corticosteroids, anticonvulsants like phenytoin, antidepressants, the antipsychotics olanzapine and lithium, antituberculosis drugs like INH, thiourea, thiouracil, disulfiram, corticotropin, antifungals like nystatin and itraconazole, hydroxychloroquine, naproxen, mercury, amineptine, chemotherapy drugs, and epidermal growth factor receptor inhibitors.Antibiotics like penicillins and macrolides cause acute generalized pustular eruption without comedones. Acne-like eruptions can develop due to infections, hormonal, or metabolic abnormalities, genetic disorders, drug reactions, contact with chemicals, or from friction and pressure 4).

As these medications can be essential to treatment of patients, it is important to recognize these conditions and understand that they can be controlled with standard acne treatments without discontinuing the medications. Acneiform drug eruptions are a monomorphic inflammatory skin disease lacking comedones with lesions typically in the same stage. Other drugs that can also induce acneiform eruptions include nystatin, isoniazid, corticotropin, naproxen, and hydroxychloroquine.Many organisms can also induce acneiform eruptions like infections by Proteus, Klebsiella, Escherichia coli, and Enterobacter.

The pathogenesis of acneiform drug eruptions is poorly understood; documented evidence when available will be presented under the specific drug …

Restated, acneiform eruptions are follicular eruptions characterized by papules and pustules resembling acne. Worsening of the lesions can be observed after each course of the treatment. There is evidence of mild inflammation with the presence of both neutrophils and eosinophils.Acneiform eruptions can be distinguished from common acne (acne vulgaris) by a history of sudden onset, monomorphic morphology, development of the eruption at any age, affecting trunk more common than the face, not necessarily affecting sebaceous areas of the body with a rarity of cyst formation.

Spontaneous regression has sometimes been reported, but telangiectasia and hyperpigmentation have been described at the site of previous lesions.Acne has also been reported in association with other tar- geted therapies, including bevacizumab, bortezomib, imatinib, infliximab, lapatinib, lenalidomide, selumetinib, sorafenib, sunitinib and vorinostat, although its incidence and severity appear, to date, less important than that associated with EGFR inhibitors. Staphylococcal follicular pustules may also be seen in wound infections. Randomized double-blind trial of prophylactic oral minocycline and topical tazarotene for cetuximab- associated acne-like eruption. Acne induced by sirolimus occurs predominantly in males (especially those with a history of severe acne vulgaris) and presents as inflammatory papulopustules distributed on the seborrhoeic regions, with an absence of comedones and cysts. Other agents Isolated reports of drug-induced acneiform eruptions associated with tricyclic antidepressants (e.g.

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