Acne miliaris necrotica

Not to be confused with Acne necrotica.

Acne miliaris necrotica
Other names	Acne varioliformis[1]
Specialty	Dermatology
Symptoms	Itchy fluid-filled bumps on typically scalp[1]
Complications	Scarring[1]
Causes	Inflammatory reaction to part of the hair follicle and S. aureus[2]
Diagnostic method	Visualisation, culture[1]
Treatment	Antibiotics[1]
Medication	Doxycycline[1]

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

Causes

The cause may be a result of an inflammatory reaction to part of the hair follicle and S. aureus.^[2]

Diagnosis

Diagnosis is by visualisation and culture of the lesions.^[1]

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

Epidemiology

History

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

See also

• List of cutaneous conditions

References

1. James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "13. Acne". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Elsevier. p. 245. ISBN 978-0-323-54753-6.
2. "Scalp folliculitis". dermnetnz.org. Retrieved 24 April 2023.
3. "Acne Necrotica (varioliformis)". www.mdedge.com. Archived from the original on 2017-11-09. Retrieved 2017-06-11.
4. "Acne Necrotica (varioliformis)". Clinical Advisor. 2016-12-20. Archived from the original on 2017-11-09. Retrieved 2017-06-11.
5. Montgomery, Hamilton (1 July 1937). "Acne miliaris necrotica of the scalp". Archives of Dermatology. 36 (1): 40. doi:10.1001/archderm.1937.01480010044006.

External links