Which condition is inflammatory cystic acne on the face of a young woman treated with prednisone and outpatient dermatology referral?

Which condition is inflammatory cystic acne on the face of a young woman treated with prednisone and outpatient dermatology referral?

• A. Acne fulminans
• B. Pyoderma Faciale
• C. Pemphigus Vulgaris
• D. SSSS

Answer: (B)

Pyoderma Faciale, also known as rosacea fulminans, fits this scenario. It is an abrupt, inflammatory, cystic facial eruption seen in otherwise healthy young women. The inflammation can be dramatic and painful but is typically localized to the face without systemic illness. Because the inflammation can be severe, a short course of systemic corticosteroids like prednisone is a common initial treatment, often followed by dermatology follow-up for ongoing management. This pattern is distinct from acne fulminans, which usually affects adolescent males and presents with fever and systemic symptoms; from pemphigus vulgaris, which features mucosal involvement and blistering with a positive Nikolsky sign; and from SSSS, which causes widespread skin sloughing, primarily in young children.

Pyoderma Faciale, also known as rosacea fulminans, fits this scenario. It is an abrupt, inflammatory, cystic facial eruption seen in otherwise healthy young women. The inflammation can be dramatic and painful but is typically localized to the face without systemic illness. Because the inflammation can be severe, a short course of systemic corticosteroids like prednisone is a common initial treatment, often followed by dermatology follow-up for ongoing management.

This pattern is distinct from acne fulminans, which usually affects adolescent males and presents with fever and systemic symptoms; from pemphigus vulgaris, which features mucosal involvement and blistering with a positive Nikolsky sign; and from SSSS, which causes widespread skin sloughing, primarily in young children.