PMC6082323_01
A few days after starting lymecycline for nodular acne of the trunk, a dramatic worsening of the clinical picture, with the occurrence of multiple, painful ulcerated nodules on the chest (A) and shoulders (B) associated with malaise and arthralgias, was observed.
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After 4 days of treatment, a dramatic onset of multiple painful, ulcerated nodules on the trunk (Figure 1), associated with mild fever, headache, and diffuse arthralgias, occurred.
Regression of inflammatory nodules after 16-week isotretinoin treatment resulting in atrophic scars.
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After 16 weeks, once the isotretinoin cumulative dose was 90 mg/kg and the inflammatory lesions had almost completely resolved in atrophic scars (Figure 2), retinoid therapy was withdrawn.
At follow-up visit 6 months after therapy cessation, no sign of relapse was observed. Some keloid scars developed on the chest (A) and shoulders (B).
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At the 6-month follow-up visit, no signs of relapse were reported, while atrophic scars had turned into keloids (Figure 3).