Acneiform Dermatitis is a broad term used to describe a group of skin conditions that resemble acne but are not true acne. These conditions typically involve inflammatory eruptions, such as papules, pustules, or nodules, usually without comedones (blackheads and whiteheads), which are characteristic of acne vulgaris.
🔍 Key Characteristics of Acneiform Dermatitis:
| Feature | Description |
|---|---|
| Appearance | Papules, pustules, or nodules resembling acne |
| Comedones | Usually absent (helps differentiate from acne vulgaris) |
| Onset | Sudden, often after a trigger |
| Common Locations | Face, chest, back, shoulders |
| Symptoms | Itching, burning, or tenderness may be present |
🧾 Causes and Triggers:
Acneiform dermatitis is not caused by clogged pores or hormonal imbalance (like acne vulgaris), but rather by external or internal triggers, such as:
Drug-Induced:
Corticosteroids (topical/systemic) – “Steroid acne”
Isoniazid, lithium, phenytoin
EGFR inhibitors (in cancer treatment)
Contact Reactions:
Cosmetics or topical creams causing irritation or allergic response
Occupational exposures (oils, tar, halogens)
Infections:
Bacterial folliculitis (infection of hair follicles)
Mechanical Irritation:
Friction from helmets, backpacks, tight clothing
Hormonal or Idiopathic:
Some cases may have unknown cause, especially in sensitive individuals
🧪 Diagnosis:
Clinical Evaluation: Based on history (sudden onset, drug use, exposure to irritants) and physical exam.
Dermoscopy or Skin Biopsy (if diagnosis is unclear): To rule out other similar conditions (e.g., acne vulgaris, rosacea, folliculitis).
💊 Treatment Options:
1. Identify & Eliminate Trigger:
Stop offending medication or exposure.
Discontinue irritating topical products.
2. Topical Therapies:
Topical antibiotics (clindamycin, erythromycin)
Benzoyl peroxide
Anti-inflammatory creams (metronidazole, calcineurin inhibitors)
3. Systemic Therapies:
Oral antibiotics (doxycycline, minocycline) if infection suspected
Antihistamines for itching
Tapering steroids if due to steroid use
4. Supportive Care:
Gentle skin care regimen
Avoid heavy cosmetics or occlusive products
🔄 Prognosis:
Generally good if the underlying trigger is removed.
May recur if the irritant is reintroduced or if chronic exposure continues.
🧠 Differential Diagnosis to Consider:
Acne vulgaris
Rosacea
Folliculitis
Perioral dermatitis
Pseudofolliculitis barbae (shaving-related)