A challenge in treating severe nodulocystic acne with keloid

Eka Syahrini; Rudi Chandra

doi:10.57662/am.v11i2.15625

A challenge in treating severe nodulocystic acne with keloid

Authors

Eka Syahrini Arosuka Regional Public Hospital, Solok regency, Indonesia
Rudi Chandra Faculty of Medicine, University of Prima Indonesia, Medan, Indonesia

Keywords:

keloid, minocycline, panthenol and zinc, salicylic acid, severe nodulocystic acne

Abstract

Introduction: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit that affects mainly adolescents. Acne can develop into refractory cysts, nodules and subcutaneous fistulas that are resistant to therapy. Keloid is a benign fibroproliferative tumor that occurs as a response to any kind of injury to the skin of susceptible individuals. Severe acne lesion become complicated with keloidal scars. Systemic treatment is indicated for the management of severe acne. However, we must be selective in choosing the right therapy for each condition. Case illustration: An 18 year old man presented with severe nodulocystic acne and multiple keloidal scars affecting his face, neck, upper chest and back. The patient was treated with oral minocycline (50 mg twice daily for 1 month and continued with 50 mg once daily for 2 months) along with topical salicylic acid (SA) and zinc (two times a day) as well as moisturizer containing 5% panthenol (two times a day). After 3 months of therapy, the patient showed a satisfying result and no adverse effects. Discussion: Minocycline has both antibacterial and anti-inflammatory properties. SA breaks down follicular keratotic plugs and promotes desquamation of the follicular epithelium, and has an anti-inflammatory effect. Moisturizer containing panthenol and zinc is helpful in the management of dryness caused by topical SA and its antibacterial properties help fight acne and regulate sebum production. Conclusion: These combination therapies are effective, safe, and may serve as an alternative treatment for severe nodulocystic acne with keloid formation.

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