Acne necrotica
Alerts and Notices
Synopsis
The acne necrotica varioliformis variant is characterized by evolution of the papules and pustules to form depressed scars resembling those seen in smallpox (varioliform). These lesions may be painful with little to no pruritus. The acne necrotica miliaria variant is characterized by small vesicopustules that form superficial crusts and erosions without scarring. These lesions tend to be very pruritic.
Codes
ICD10CM:L70.2 – Acne varioliformis
SNOMEDCT:
402923008 – Acne necrotica varioliformis of scalp margin
45072005 – Acne necrotica miliaris
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Folliculitis – May be present elsewhere on the body and have sustained response to antibiotics
- Folliculitis decalvans – Most frequently affects the crown; biopsy demonstrates a predominantly neutrophilic infiltrate
- Acne vulgaris – comedones present and earlier onset
- Dissecting cellulitis of the scalp
- Ofuji disease
- Lupus miliaris disseminatus faciei
- Erosive pustular dermatosis of the scalp
- Tinea capitis
- Molluscum contagiosum
- Herpes zoster
- Eczema herpeticum
- Acne excoriée
- Dermatitis artefacta
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:08/24/2020
Last Updated:09/21/2020
Last Updated:09/21/2020