Acne and Drug Reactions

Abstract

Acne vulgaris is a chronic disease of the pilosebaceous follicle and it is characterized by any combination of open comedones, closed comedones, pustules, cysts, and scarring of varying severity. Factors which promote the development of acne are: increased sebum production, which is influenced by endogenous androgens; ductal hypercornification; abnormal follicular keratinization; colonization of the pilosebaceous ducts by Propionibacteria acnes; inflammation; and genetic predisposition. While the majority of acne cases are hormone-dependent juvenile acne, a subset of cases are drug induced, which is defined as the development of an acneiform eruption occurring after medication intake. Several classes of drugs are associated with acneiform eruptions and include: corticosteroids, neuropsychotherapeutic drugs, antituberculosis drugs, immunomodulating drugs, and targeted therapy in the field of oncology. Discontinuation of the drug will lead to recovery from the acneiform eruption, but is rarely mandatory, given the benign nature of acne. The idiopathic disease can be distinguished from the drug eruption by characteristics of presentation, unusual age on onset, unusual location of the lesions, and resistance to conventional acne therapy.