A 20-year-old male patient had a 12x10 cm large Becker's nevus on the sternal region since he was eight. During the last year pustular and deep inflammatory nodulocystic acne appeared exclusively in the nevus area. We prescribed isotretinoine 40 mg daily, which is about 0.5 mg/kg of his body weight. After 6 months his condition improved, but after 10 months and a cumulative dosage of 154 mg/kg, his condition in not satisfactory. He has still fluctuating collections of pus in the medial part of the nevus. Should we insist on isotretinoine? Should we increase the dosage? He is not enthusiastic about surgical treatment, and we neither because of possible keloids. Any other treatment option? The attached picture was taken after six months of treatment.
Can the lesions be folliculitis ?
Can you try Clindamicyn 300 mg 2 or 3 id for 21 days ?
Regards
af
The skin eruptions are more paplable than visible. At the beginning I puncture them and sqeezed out, beside pus, also some greasy masses. So, there are cysts. Only a few case reports of acne within Becker's nevus have been published. It has been noted that they are difficult to treat and can recur.
Thanks a lot for your suggestion. Since isotretinoine seems to be ineffective, Clindamycin could be a valuable option.
Best regards!
Try also maybe AZELAIC ACID TOPICALLY and if Clindamicin won,t work try also Doxiciclyne
Please keep us in touch
Use Doxiciclyne if clindamycin not give you within 3 weeks good results .
Regards
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