Acne miliaris necrotica

Acne miliaris necrotica is a severe form of folliculitis of typically the scalp. It presents as multiple fluid-filled bumps, sometimes occurring as solitary lesions that are usually very itchy. Shortly after appearing, the bumps burst and dry up. There may be scarring.

Causes
The cause may be a result of an inflammatory reaction to part of the hair follicle and S. aureus.

Diagnosis
Diagnosis is by visualisation and culture of the lesions.

Treatment
There are multiple medications that are able to treat acne varioliformis.

Topical

 * Clindamycin 1% lotion or Benzoyl peroxide/clindamycin gel
 * Erythromycin 2% gel
 * 1% hydrocortisone cream

Systemic

 * Doxycycline 50 mg twice daily
 * Isotretinoin 0.5 mg/kg daily

History
The condition was first described by Sabouraud in 1928.