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January 1989

Acne Fulminans Associated With Painful Splenomegaly

Author Affiliations

Departments of Internal Medicine (DvS) and Dermatology University Hospital PO Box 9600 2300 RC Leiden, the Netherlands

Arch Dermatol. 1989;125(1):132-133. doi:10.1001/archderm.1989.01670130134024

To the Editor.—  Acne fulminans is a severe form of acne that may be complicated by a variety of systemic inflammatory manifestations, such as fever, an elevated erythrocyte sedimentation rate, and sometimes extreme, leukocytosis.1 Arthritis,2 osteolytic lesions,3 microscopic hematuria,4 and erythema nodosum with circulating immune complexes5 have also been described. It is generally assumed that the systemic complications are caused by an immunologic disorder. This is supported by the rapid recovery following systemic corticosteroid therapy in nearly all cases. We present a case of acne fulminans with yet another inflammatory complication, namely, a painful swelling of the spleen.

Report of a Case.—  An 18-year-old man presented to the internal medicine department because of severe pain in the left upper abdomen. In the weeks before, his acne vulgaris had dramatically deteriorated. He appeared moderately ill and had a low-grade fever. There were many erythematous plaques with