An acneiform drug eruption is considered to be an important cutaneous drug-induced adverse effect. It has been described in patients taking both topical and systemic drugs [1], with the most involved classes being antimicrobials (tetracycline, streptomycin, isoniazid, clofazimine, and antimycotics), central nervous system (CNS)-acting agents (lithium, phenobarbital, and hydantoin derivatives such as phenytoin), chemotherapeutics (epidermal growth factor receptor - EGFR inhibitors such as cetuximab, erlotinib, and gefitinib, but also cyclosporin A), interferon (IFN), gold salts, etc. [1] [2] [3] [4]. Corticosteroids, in topical as well as systemic formulations, are particularly associated with an acneiform drug eruption in women [1]. The typical signs are characterized by the onset of skin lesions within several days after the introduction of drugs [5]. Erythematous follicular papules are the hallmark of an acneiform drug eruption [1] [3] [5] [6]. These lesions develop on the face, but also on the extremities, particularly on the forearms and buttocks, whereas the shoulders, the retroauricular area, and the superior portion of the trunk might serve as additional locations [1] [3] [5] [6]. The papules are further differentiated from acne vulgaris by the formation of punctiform vesicles in the center, followed by vesiculopustular progression [1]. Additional findings that exclude acne vulgaris are the absence of comedones that should normally precede the formation of acne, the older age of the patient (acne are primarily seen in adolescence), accompanying signs of systemic drug toxicity (eg. fever or malaise), and resolution of lesions after discontinuation of the drug [1] [5].

The diagnosis of an acneiform drug eruption rests on the ability of the physician to identify the key findings and establish the underlying cause. For this reason, a thorough patient history and a detailed physical examination are main steps in order to raise suspicion toward this entity. Recent administration of the previously mentioned pharmacological agents is perhaps the crucial piece of information that can be obtained. Other patient details, such as age, the presence of underlying disorders for which these drugs are used, and the pattern of rash distribution are equally important for making a presumptive diagnosis. Recognition of an acneiform drug eruption is mainly based on clinical grounds, but a biopsy with subsequent histopathological examination can be performed. Typical findings include spongiosis, disruption of the follicular epithelium and a nonspecific inflammatory reaction with both lymphocytes and neutrophils [5], whereas a suppurative follicular inflammation with a dense neutrophilic infiltrate is reported by other authors [6].

The primary treatment for acneiform drug eruption is discontinuation of the offending medication, if possible. Once the drug is stopped, the lesions typically resolve on their own. In cases where the medication cannot be discontinued, topical treatments such as benzoyl peroxide or retinoids may be used to manage the symptoms. Oral antibiotics may also be prescribed to reduce inflammation and bacterial growth.

The prognosis for acneiform drug eruption is generally good. Once the causative medication is discontinued, the skin lesions usually resolve within a few weeks. There is typically no scarring, and the condition does not lead to long-term skin damage. However, if the medication is continued, the eruptions may persist or worsen.

Acneiform drug eruptions are caused by a variety of medications. Common culprits include corticosteroids, certain antibiotics, anticonvulsants, and some cancer therapies. The exact mechanism by which these drugs cause acne-like eruptions is not fully understood, but it is believed to involve an inflammatory response in the skin.

Acneiform drug eruptions can affect individuals of any age, gender, or ethnicity. The incidence is not well-documented, but it is considered relatively uncommon. The risk of developing this condition depends on the specific medication and the individual's sensitivity to it.

The pathophysiology of acneiform drug eruptions involves an inflammatory response in the skin. Unlike typical acne, which is caused by blocked hair follicles and excess oil production, drug-induced eruptions are thought to result from an immune response to the medication. This leads to the formation of papules and pustules that resemble acne.

Preventing acneiform drug eruptions primarily involves careful monitoring of medications. Patients should be informed about the potential side effects of new medications, and healthcare providers should consider alternative treatments if a patient has a history of drug-induced skin reactions. Regular follow-up can help detect and address any skin changes early.

Acneiform drug eruption is a skin condition characterized by sudden acne-like lesions caused by certain medications. It presents with red, inflamed papules and pustules, primarily on the face, chest, and back. Diagnosis involves identifying recent medication changes, and treatment focuses on discontinuing the offending drug. The prognosis is generally good, with lesions resolving after the drug is stopped. Understanding the medications that can cause this condition is key to prevention and management.

If you experience a sudden outbreak of acne-like lesions after starting a new medication, it may be an acneiform drug eruption. This condition is caused by certain drugs and can appear on the face, chest, and back. It is important to inform your healthcare provider about any new medications you are taking. Treatment usually involves stopping the medication, which leads to the resolution of the skin lesions. If stopping the medication is not possible, topical treatments can help manage the symptoms. The condition is not serious and typically resolves without long-term effects once the medication is discontinued.

1. Rosa DJ, Matias FAT, Cedrim SD, Machado RF, Sá AA, Silva VC. Acute acneiform eruption induced by interferon beta-1b during treatment for multiple sclerosis. An Bras Dermatol. 2011;86:336–338.
2. Du-Thanh A, Kluger N, Bensalleh H, Guillot B.Drug-induced acneiform eruption. Am J Clin Dermatol. 2011;12(4):233-245
3. Pontello Junior R, Kondo RN. Drug-induced acne and rose pearl: similarities. An Bras Dermatol. 2013;88(6):1039-1040.
4. Plewig G, Jansen T. Acneiform dermatoses. Dermatology. 1998;196(1):102-107.
5. Segaert S, Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol. 2005;16:1425–1433.
6. Lee JE, Lee SJ, Lee HJ, Lee JH, Lee KH. Severe acneiform eruption induced by cetuximab (Erbitux) Yonsei Med J. 2008;49:851–852