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Acne inversa complicated by Actinomyces neuii

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Abstract

Introduction

Acne inversa (AI) is a chronic and recurrent inflammatory skin disease. It occurs in intertriginous areas of the skin and causes pain, drainage, malodor and scar formation. While supposedly caused by an autoimmune reaction, bacterial superinfection is a secondary event in the disease process.

Methods

A unique case of a 43-year-old male patient suffering from a recurring AI lesion in the left axilla was retrospectively analysed.

Results

A swab revealed Actinomyces neuii as the only agent growing in the lesion. The patient was then treated with Amoxicillin/Clavulanic Acid 3 × 1 g until he was cleared for surgical excision. The intraoperative swab was negative for A. neuii. Antibiotics were prescribed for another 4 weeks and the patient has remained relapse free for more than 12 months now.

Conclusion

Primary cutaneous Actinomycosis is a rare entity and the combination of AI and Actinomycosis has never been reported before. Failure to detect superinfections of AI lesions with slow-growing pathogens like Actinomyces spp. might contribute to high recurrence rates after immunosuppressive therapy of AI. The present case underlines the potentially multifactorial pathogenesis of the disease and the importance of considering and treating potential infections before initiating immunosuppressive regimens for AI patients.

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Fig. 1

References

  1. Gill L, Williams M, Hamzavi I. Update on hidradenitis suppurativa: connecting the tracts. F1000Prime Rep. 2014;6:112.

    PubMed  PubMed Central  Google Scholar 

  2. Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158–64.

    Article  CAS  PubMed  Google Scholar 

  3. von Laffert M, Helmbold P, Wohlrab J, Fiedler E, Stadie V, Marsch WC. Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis. Exp Dermatol. 2010;19(6):533–7.

    Article  Google Scholar 

  4. van der Zee HH, Laman JD, Boer J, Prens EP. Hidradenitis suppurativa: viewpoint on clinical phenotyping, pathogenesis and novel treatments. Exp Dermatol. 2012;21(10):735–9.

    PubMed  Google Scholar 

  5. Sartorius K, Killasli H, Oprica C, Sullivan A, Lapins J. Bacteriology of hidradenitis suppurativa exacerbations and deep tissue cultures obtained during carbon dioxide laser treatment. Br J Dermatol. 2012;166(4):879–83.

    Article  CAS  PubMed  Google Scholar 

  6. Valour F, Senechal A, Dupieux C, Karsenty J, Lustig S, Breton P, et al. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Res. 2014;7:183–97.

    Google Scholar 

  7. Gomez-Garces JL, Burillo A, Gil Y, Saez-Nieto JA. Soft tissue infections caused by Actinomyces neuii, a rare pathogen. J Clin Microbiol. 2010;48(4):1508–9.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bennhoff DF. Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases. Laryngoscope. 1984;94(9):1198–217.

    Article  CAS  PubMed  Google Scholar 

  9. Blok JL, van Hattem S, Jonkman MF, Horvath B. Systemic therapy with immunosuppressive agents and retinoids in hidradenitis suppurativa: a systematic review. Br J Dermatol. 2013;168(2):243–52.

    Article  CAS  PubMed  Google Scholar 

  10. Breton AL, Lamblin G, Pariset C, Jullien D. Cutaneous actinomycosis associated with anti-TNF-alpha therapy: report of two cases. Dermatology. 2014;228(2):112–4.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

    Jakob Nedomansky & Stefanie Nickl

  2. Division of Immunology, Department of Dermatology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria

    Doris Weiss

  3. Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria

    Birgit Willinger

  4. Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria

    Christoph Steininger

Authors
  1. Jakob Nedomansky
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  2. Doris Weiss
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  3. Birgit Willinger
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  4. Stefanie Nickl
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  5. Christoph Steininger
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Corresponding author

Correspondence to Christoph Steininger.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Nedomansky, J., Weiss, D., Willinger, B. et al. Acne inversa complicated by Actinomyces neuii . Infection 44, 247–249 (2016). https://doi.org/10.1007/s15010-015-0814-6

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  • DOI: https://doi.org/10.1007/s15010-015-0814-6

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