Abstract

Acne vulgaris (AV) is categorised by lesions resulting from inflammation of pilosebaceous units. Truncal acne refers to AV upsetting the chest and/or back and is exists in almost 50% of patients with facial acne, but is also sometimes seen in isolation. Oral antibiotics are broadly suggested for truncal acne owing to the challenges of applying topical therapy to such an extensive body surface area. In many cases of mild, moderate, or even severe truncal acne, mixtures of topical therapies may be valid alternatives. The introduction of foam preparations with improved percutaneous absorption and tretinoin lotion formulations that include moisturizing/hydrating agents challenges the earlier held idea that effective and bearable treatment of truncal acne involves oral treatment. We are describing here a case of truncal acne effectively treated with a combination of tretinoin lotion 0.05% and azelaic acid 15% foam.

Case Report

A 27-year-old female, came with a 2-year history of severe back acne, frequent breakouts, and worries about the dark spots that left behind. The patient had no facial acne or hyperpigmentation, and the skin was soft, smooth, and healthy. AV was leading on her chest and her back. Hyperpigmented macules were present on her chest and back, along with hyperpigmented papules and pustules.

Tretinoin lotion 0.05% was advised for its tretinoin concentration (0.05%), particle size (85% less than 10 microns), and homogenous distribution as well as its unique formulation with added hyaluronic acid and collagen, which would help in decreasing dryness and irritation.

She was also prescribed azelaic acid foam 15% for use on her back, twice daily. Azelaic acid foam have a lightening effect on the skin.

The patient was asked to come after 4 weeks. At this time, she expressed satisfaction with the treatment. She stated that the dark spots looked much lighter and that she had not had a flare-up since the first visit. On examination, the postinflammatory hyperpigmentation was noticeably lightened. There was no itching or burning sensations where the tretinoin 0.05% lotion had been applied.

After 12-week follow-up, there was no sign of acne.

Conclusion

Topical retinoids are extremely effective and are suggested as first line therapy in mild-to-moderate acne. The mixture of tretinoin 0.05% lotion and azelaic acid 15% foam showed constant development.

Suggested Reading

1. M. A. Dagnelie, E. Montassier, A. Khammari, C. Mounier, S. Corvec, and B. Dréno, “Inflammatory skin is associated with changes in the skin microbiota composition on the back of severe acne patients,” Experimental Dermatology, vol. 28, no. 8, pp. 961–967, 2019.View at: Publisher Site | Google Scholar
2. L. Culp, S. Moradi Tuchayi, H. Alinia, and S. R. Feldman, “Tolerability of topical retinoids:are there clinically meaningful differences among topical retinoids?” Journal of Cutaneous Medicine and Surgery, vol. 19, no. 6, pp. 530–538, 2015.View at: Publisher Site | Google Scholar
3. L. H. Kircik, Z. D. Draelos, and D. S. Berson, “Polymeric emulsion technology applied to tretinoin,” Journal of Drugs in Dermatology, vol. 18, no. 4, pp. S148–S154, 2019.View at: Google Scholar
4. G. Webster, “Combination azelaic acid therapy for acne vulgaris,” Journal of the American Academy of Dermatology, vol. 43, no. 2, pp. S47–S50, 2000.View at: Publisher Site | Google Scholar