Acne vulgaris in the context of complex medical co-morbities: the management of severe acne vulgaris in a female with retinitis pigmentosa - utilizing pulse dye laser in conjunction with medical therapy

Dermatol Online J. 2014 Mar 17;20(3):doj_21763.

Abstract

Acne vulgaris is a pervasive inflammatory disorder of the skin, with multiple etiologies and treatment options. Although first-line therapies exist, it is often the case that a patient will present with an underlying disorder that prohibits the use of most currently accepted treatment modalities. We present a patient with severe acne vulgaris and a history of retinitis pigmentosa who was treated with 595 nanometer pulsed dye laser therapy, in conjunction with therapeutic alternatives to first-line acne medications. Our patient exhibited a significant and sustained improvement with the combined use of 595 nanometer pulsed dye laser, Yaz (drospirenone-ethinyl estradiol), dapsone, topical metronidazole, sodium-sulfacetamide wash, and topical azelaic acid. The positive results in this case, suggest that this combined treatment modality may serve as an example of a safe and effective treatment alternative in the management of acne vulgaris complicated by medical co-morbidities that contraindicate the use of most first-line treatment options.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Acne Vulgaris / complications
  • Acne Vulgaris / radiotherapy*
  • Administration, Cutaneous
  • Adult
  • Androstenes / therapeutic use
  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use
  • Combined Modality Therapy
  • Contraindications
  • Dapsone / therapeutic use
  • Dicarboxylic Acids / administration & dosage
  • Dicarboxylic Acids / therapeutic use
  • Ethinyl Estradiol / therapeutic use
  • Female
  • Humans
  • Lasers, Dye / therapeutic use*
  • Metronidazole / administration & dosage
  • Metronidazole / therapeutic use
  • Mineralocorticoid Receptor Antagonists / administration & dosage
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Photosensitizing Agents
  • Retinal Detachment / prevention & control
  • Retinitis Pigmentosa / complications*
  • Rosacea / complications
  • Rosacea / radiotherapy
  • Sulfacetamide / therapeutic use
  • Telangiectasis / etiology
  • Telangiectasis / radiotherapy

Substances

  • Androstenes
  • Anti-Infective Agents, Local
  • Dicarboxylic Acids
  • Mineralocorticoid Receptor Antagonists
  • Photosensitizing Agents
  • drospirenone and ethinyl estradiol combination
  • Metronidazole
  • Ethinyl Estradiol
  • Sulfacetamide
  • Dapsone
  • azelaic acid