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A Bad Case of Acne?

A Bad Case of Acne?

Case and photo courtesy of Ted Rosen, MD

A 26-year-old African American woman was concerned about the gradual onset of mildly tender, but severely distressing facial lesions. She had not sought medical attention previously because of a lack of insurance and assurances by her mother that this was only “bad acne.” Use of a popular over-the-counter benzoyl peroxide–based acne kit brought no improvement, however.

What features would lead you to rule acne in—or out—and what other diagnoses would you consider?

Please leave your comments and click here for a summary discussion.

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