Acne in case of CF

Question

Dear expert team,
are there any other possibilities to treat an acne conglobata of a CF patient? Isotretinoin and antibiotics have unfortunately not brought an improvement of the skin picture.
Many thanks in advance and best regards,

Answer

Dear questioner,
you ask in your e-mail about therapeutical options of an acne conglobata in case of a CF patient. In order to answer your question in a competent manner, we addressed additionally to a dermatologist (Dr. Eva Valesky).
The therapy of an acne of a CF patient is not different from the one of other patients. However, we can not conclude from your question, if you have up to now been treated only locally or also already systemically (tablets or injections), as both preparations are also available for the local use. In case there has no systemical therapy been initiated up to now, a systemic treatment is in general started. We are telling in the following further therapeutic optinons, that you should however in any case discuss with your treating dermatologist.
As an example, isotretinoin could be started (due to your CF illness cautiously) with about 0.2-0.3mg/kg body weight, in case of a strong inflammation probably in combination with prednisolon orally (20-40mg/day). The systemic treatment could be extended with dapson (caution: methemoglobinaemia in case of glucose-6-phospate deficiency). The local treatment could be done e.g. with adapalen and benzoylperoxide.
In case of severe cystic abscesses one could after a sterile punction also inject steriods in a cristal suspension into the cystic structures.

We hope to have helped you with the answer and again point out, that one can give only information via the internet however no counselling!

Best regards,
Yours
Dr. med. Eva Valesky and Dr. med. Christina Smaczny

13.10.2014