Acne miliaris necrotica explained

Acne miliaris necrotica
Synonyms:	Acne varioliformis
Field:	Dermatology
Symptoms:	Itchy fluid-filled bumps on typically scalp
Complications:	Scarring
Causes:	Inflammatory reaction to part of the hair follicle and S. aureus
Diagnosis:	Visualisation, culture
Treatment:	Antibiotics
Medication:	Doxycycline

Acne miliaris necrotica is a severe form of folliculitis of typically the scalp.^[1] It presents as multiple fluid-filled bumps, sometimes occurring as solitary lesions that are usually very itchy.^[2] Shortly after appearing, the bumps burst and dry up.^[2] There may be scarring.^[2]

Causes

The cause may be a result of an inflammatory reaction to part of the hair follicle and S. aureus.^[1]

Diagnosis

Diagnosis is by visualisation and culture of the lesions.^[2]

Treatment

There are multiple medications that are able to treat acne varioliformis.^{[3] [4]}

Topical

• Clindamycin 1% lotion or Benzoyl peroxide/clindamycin gel
• Erythromycin 2% gel
• 1% hydrocortisone cream

Systemic

• Doxycycline 50 mg twice daily
• Isotretinoin 0.5 mg/kg daily

History

The condition was first described by Sabouraud in 1928.^[5]

See also

• List of cutaneous conditions

Notes and References

1. Web site: Scalp folliculitis . dermnetnz.org . 24 April 2023.
2. Book: James . William D. . Elston . Dirk . Treat . James R. . Rosenbach . Misha A. . Neuhaus . Isaac . Andrews' Diseases of the Skin: Clinical Dermatology . 2020 . Elsevier . 978-0-323-54753-6 . 245 . 13th . https://books.google.com/books?id=UEaEDwAAQBAJ&pg=PA245 . en . 13. Acne.
3. Web site: Acne Necrotica (varioliformis). www.mdedge.com. 2017-06-11. https://web.archive.org/web/20171109191211/http://www.mdedge.com/cutis/dsm/617/acne/acne-necrotica-varioliformis. 2017-11-09. dead.
4. News: Acne Necrotica (varioliformis). 2016-12-20. Clinical Advisor. 2017-06-11. en. 2017-11-09. https://web.archive.org/web/20171109191145/http://www.clinicaladvisor.com/dermatology/acne-necrotica-varioliformis/article/592037/. dead.
5. Montgomery . Hamilton . Acne miliaris necrotica of the scalp. Archives of Dermatology . 1 July 1937 . 36 . 1 . 40 . 10.1001/archderm.1937.01480010044006 .