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Drug-induced acneiform rash

FEATURED REVIEW Acne is a generally mild skin condition, common among adolescents and young adults. Certain toxins and drugs can aggravate pre-existing acne or cause acneiform rash. Various pharmacological classes can cause acneiform rash. The eruptions usually subside after drug withdrawal, but sometimes only after several months.
Full review (3 pages) available for download by subscribers.

Key points 

  • Acne is a mild skin disorder, common among adolescents and young adults.
  • Acne is characterized by comedones, which are absent in acneiform rash. Microcysts develop first, leading to typical inflammatory lesions located in specific body areas (face and upper thorax). Exacerbations occur with no clear triggering factor. Acne is usually persistent but generally resolves spontaneously.
  • Acne usually develops under the action of androgens. Acne and acneiform rash can be linked to diseases, drugs or toxins.
  • Drug-related acne should be suspected in the following circumstances: sudden onset, atypical locations, absence of comedones, unusual age for acne onset, and ineffectiveness of acne treatments. These eruptions usually resolve when the implicated drug is withdrawn, but sometimes only after several months.
  • Numerous drugs belonging to various pharmacological classes can cause acneiform rash, especially drugs with androgenic activity, cetuximab, lithium, phenytoin, immunosuppressants, steroids, and some anti-infectives.

©Prescrire October 2010

"Drug-induced acneiform rash" Prescrire Int 2010; 19 (109): 214-216. (Pdf, subscribers only).

Download the full review.