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| Fig. 21.4 Pyoderma faciale. A, This fulminant eruption developed when the patient was tapered off systemic corticosteroids. B, Same patient after treatment with a tapered course of prednisone and Accutane. The eruption did not recur. |
This is an acute, ferocious skin disease of women aged 15 to 40. It strikes like a hurricane, often in patients with no previous history of acne. It most commonly involves the central face but may affect the upper trunk. It is characterized by severe pustules, nodules, cysts, and draining sinus tracts (Fig. 21-4). Many of the patients have a history of flushing, and some authors regard it as a severe variant of acne rosacea. It has been reported in some patients during pregnancy or immediately postpartum.
