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Induction of acne by topical steroids

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Summary

An acneforme eruption was regularly induced in human adult male volunteers by topical application of corticosteroid solutions and various commercial creams. Within 7 to 14 days smooth, firm, dome-shaped, reddish papules of rather uniform size appeared followed by comedones several weeks later. Factors promoting the development of steroid acne were (I) high concentrations, (II) continuous occlusion, (III) young adults below age 30, (IV) whites in preference to blacks, (V) history or signs of acne, (VI) applications to acne areas of face and upper back. Increased formation of horny cells was demonstrated by radiolabelling with3H-thymidine,3H-glycine and3H-histidine. Histologically, the first event was a focal degeneration of the follicular epithelium with the formation of a circumscribed intra- and perifollicular abscess.

Zusammenfassung

Akneartige Efflorescenzen wurden regelmäßig bei männlichen erwachsenen Probanden durch Lokalapplikation von glucocorticosteroidhaltigen Lösungen und verschiedenen kommerziellen Fertigpräparaten erzeugt. Innerhalb von 7 bis 14 Tagen traten glatte, feste, kuppelförmige und entzündlich gerötete uniforme Papeln auf. Daraus entwickelten sich einige Wochen später Comedonen. Folgende Faktoren förderten die Ausbildung einer Steroid Acne: (I) der Gebrauch hochkonzentrierter Steroidzubereitungen, (II) eine fortlaufende Okklusivbehandlung, (III) ein Alter unter 30 Jahren, (IV) Kaukasier im Gegensatz zu Negern, und (V) die Anamnese einer durchgemachten oder noch persistierenden Acne vulgaris. Die Kinetik der Comedonenbildung wurde autoradiographisch mit3H-Thymidin,3H-Glycin und3H-Histidin verfolgt. Eine beschleunigte Hornzellbildung im oberen Follikelabschnitt wurde nachgewiesen. Histologisch war das früheste Ereignis eine umschriebene Spongiose und Nekrose im Follikelepithel mit nachfolgendem intra- und perifollikulärem Absceß.

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Authors and Affiliations

  1. Department of Dermatology, University of Munich, Munich, FRG

    Gerd Plewig

  2. Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA

    Albert M. Kligman

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  1. Gerd Plewig
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  2. Albert M. Kligman
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Plewig, G., Kligman, A.M. Induction of acne by topical steroids. Arch. Derm. Forsch. 247, 29–52 (1973). https://doi.org/10.1007/BF00595699

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