MIAMI BEACH — Be vigilant for acne vulgaris on the trunk because almost half of acne patients might have it on their shoulders, chest, or back, according to a presentation at a symposium sponsored by the Florida Society of Dermatology and Dermatologic Surgery.
Assessment of acne patients for truncal involvement is important because “not all patients will tell you about it,” said James Q. Del Rosso, D.O., of the department of dermatology, University of Nevada, Las Vegas.
A recent treatment option for acne of the trunk is clindamycin phosphate 1% (Evoclin Foam, Connetics Corp).
In October 2004, the Food and Drug Administration approved the once-daily acne vulgaris topical treatment for patients aged 12 years and older.
Dr. Del Rosso disclosed that he is a consultant, advisory board member, and member of the speakers' bureau for Connetics Corp.
To determine a ballpark figure of the frequency of involvement of acne on the trunk, Dr. Del Rosso examined 100 consecutive patients with acne who were at least 16 years of age (range of 16–30 years). “I found 94% had facial acne vulgaris, which is to be expected,” he said.
In 44% of patients, there was truncal acne. Men were more likely to have this type of acne (61%), compared with women (41%).
Patient age often correlates with the location and type of acne vulgaris. In preteens, for example, acne tends to be centrofacial with predominantly comedonal lesions.
In teenagers, acne is located on the face or trunk and typically presents as a mixture of comedonal and inflammatory acne.
Adult females, on the other hand, can present with acne on perioral, chin, lower cheek, jawline, neck, and trunk areas. Inflammatory lesions are most common in this population.
The differential diagnosis of acne vulgaris on the trunk is aided by looking for lesions at different stages, Dr. Del Rosso said. In contrast, monomorphic lesions usually indicate other conditions such as hot tub folliculitis or “corticosteroid acne.”