|Year : 2000 | Volume
| Issue : 5 | Page : 272-273
Source of Support: None, Conflict of Interest: None
A rare case of a 15-month old girl who presented with true comedones, papules and occasional pustules over both cheeks of 6 months duration after the child was weaned off breast milk.
Keywords: Infantile acne, Acne
|How to cite this article:|
Krishnan K. Infantile acne. Indian J Dermatol Venereol Leprol 2000;66:272-3
| Introduction|| |
"Grouped comedones" in infants and children were first described by Radcliffe- Crocker in 1984.  Although non-specific follicular occlusion is frequently seen due to application of oils on the face, true acne vulgaris in infancy is rare.  Hellier has divided acneform eruptions in infancy into two groups (1) appears in first few weeks of life (true acne neonatorum) and (2) appears when the child is about one year old. 
| Case Report|| |
A 15-month-old girl presented with true comedones, erythematous and skin coloured pinhead sized papules and occasional pustules over both cheeks [Figure - 1] of 6 months duration. There was no history of similar acne lesions during the neonatal period or history of severe teenage acne vulgaris in either parent. The lesions started at about 3 months of age. There was no history of application of oils or skin ointments or any history of intake of hormonal drugs during pregnancy and urinalysis were within normal limits. Skin biopsy was refused by the parents, in view of the potential for self resolution.
| Discussion|| |
Acne in infancy presents with true comedones, inflamed papules and small pustules localised to the face predominantly on cheeks.
Sometimes cystic lesions, cold abscesses and conglobate lesions may be associated.  Onset is usually between 1 week to 3 years of age, with a strong male predominance. ,
Although the exact etiology of infantile acne is not known, Rothman proposed a genetically determined high degree of sensitivity of pilosebaceous apparatus to endocrine stimuli. Some cases present with increased levels of urinary 17-ketosteroids (normal 24 hour urinary 17 ketosteroid level for a child less than 1 month old is< 1.5 ng/24 hours).  Exceptionally, infantile acne may be associated with excess of androgens e.g in Cushing's syndrome. Normally, the hypothalamo-pituitary- gonadal negative feed back mechanism has increased threshold at birth. It gradually gets lowered from 7 months of age upto puberty, when it again gets raised. Rarely, prolonged period of immaturity of the gonadostat with a high threshold of sensitivity may result in infantile acne. 
The lesions usually clear spontaneously within 1-2 months, though others may persist upto 11 years. , Some cases after remaining clear throughout childhood, then manifest severe teenage acne. 
The peculiarities of this extremely rare case of infantile acne were (1) female sex (2) comparatively late onset at the age of 9 months, after the child was weaned off breast milk (3) negative family history of severe acne in either parent.
| References|| |
|1.||Hellier FF. Acneform eruptions in infancy. Br J Dermatol 1954 ; 66: 25 - 30. [PUBMED] |
|2.||Tromovitch TA, Abramo AA, Jacobs PH. Acne in infancy. Am 3 Dis Child 1963; 106:230-231. |
|3.||Duke EMC. Infantile acne associated with transient increases in plasma concentrations of luteinising hormone follicle - stimulating hormone and testosterone. Br Med J 1981; 282:1275-1276. |
[Figure - 1]