-
Views
-
Cite
Cite
Y. Shimomura, S. Nomoto, S. Yamada, A. Ito, K. Ito, M. Ito, Chronic glomerulonephritis remarkably improved after surgery for acne conglobata of the buttocks, British Journal of Dermatology, Volume 145, Issue 2, 1 August 2001, Pages 363–364, https://doi.org/10.1046/j.1365-2133.2001.04362.x
Close - Share Icon Share
Extract
Sir, Acne conglobata is a chronic inflammatory disease with multiple comedones, pustules, abscesses and scars commonly affecting the trunk and buttocks. Local hyperhidrosis, poor personal hygiene or mechanical factors may contribute to the buttock lesions; however, although immunological disorders1 or hormonal abnormalities2 have been suggested to be important in this disorder, its precise pathogenesis is still unknown. Some reports have described acute glomerulonephritis or renal amyloidosis associated with acne conglobata.3–5 In these cases, the renal diseases were irreversible and progressive despite successful treatment of the cutaneous lesions. We present a patient with chronic glomerulonephritis associated with severe acne conglobata of the buttocks, in whom the renal disease remarkably improved after radical surgical treatment of the cutaneous disease.
A 47‐year‐old Japanese man had suffered from multiple folliculitis‐like eruptions on his buttocks, trunk and nape of the neck for about 30 years. Although various conservative therapies had been used, the abscesses on the buttocks had gradually aggregated and grown to form ugly scarring plaques and nodules with draining fistulae (Fig. 1). Microscopic haematuria and proteinuria were detected at the age of 43 years. Blood analysis showed severe iron‐deficiency anaemia (haemoglobin 6·5 g dL−1), white cell count 13·6 × 109 L−1 with 82% neutrophils, and erythrocyte sedimentation rate 91 mm in the first hour. Total protein, serum albumin and γ‐globulin levels were 8·9, 2·6 and 4·4 g dL−1, respectively. Serum M‐component was absent. Immunological studies showed high levels of IgG, IgA, C3d‐binding and C1q‐binding immune complexes. No other immunological abnormalities were found. Blood sugar estimation showed prediabetes. The serum creatinine level was 1·3 mg dL−1. Urinalysis showed a high level of occult blood and mild proteinuria of 1·18 g day−1. Renal biopsy showed mesangial proliferative progressive glomerulonephritis without amyloid deposition. Approximately 40% of glomeruli showed sclerotic change. There was no evidence of internal or cutaneous malignancy.
