What is Acne urticata ? and how to treat them ?

 Acne Urticata :

Acne urticata is a term that is not often used today . It describe very itchy papules or prurigo  that affects  the face , neck  and  cape area. it is not  actually acne . it is not  actually acne .  It is not  clear  whether acne urticata is a unique disorder . lesions described as acne urticata may be localised  form of compulsive  skin picking . others confined  to sun  exposed  sites are likely a form polymorphous light erupation . The cutaneous manifestations  most frequently  associated withpolycythemia vera are a purlish -red discoloration of the ksin and mucous membranes and ecchymoses particular  over the lower extreities . Both of these manifestation  are readily  understandable  on the bais of the increase  in total red cell volume characteristic of this disease .

These  commoner cutaneous  manifestations , acne urticata has been described in association  with polycythemia  vera  more  frequently  than any other eruption . The term acne urticata was first used  by Kaposi to designate a chronic , severely  pruritic  eruption characterized  by the  development  of pale  red  elevated  wheal - like papules ranging  from the size of a pea to that of a small coin , surmounted by a vesicle with turbid contents . the vesicle    or pustule is rapidly  excoriated, and the surface of the papule become crusted . Involution occurs,  crusted. involution occurs , with  the formation of a delicate scar and hyperpigmentation .

What are the causes of acne urticata ?

The causes of acne urticata is not understood . it may be due to an innate immune reaction within the hair follicle , resulting  in the production  of pruritogenic substances , a neuropathic form of pruritus , or psychogenic  in origin  . Although women with acne urticata are often under stress , it is hard to know whether the stress  precedes the rash or whether the stress is caused by the rash 's itchiness .

In acne urticata , small bumps , blisters and pustules arise in the  " cape " area of the body ie the face scalp , neck , upper arms and upper trunk . They are so intensely itchy that they are rapidly scratched or picked . This leaves unsightly , crusted lesions , which may then leave permanent small white scars . 

How to treat acne urticata ?

Acne urticata is difficult to treat effectively and may persist for years . the following may be useful :

1. topical corticosteroids 

2. long courses of oral antibiotics , usually a tetracycline 

3. ultraviolet treatment . This is not suitable if the papules are provoked by exposure to light 

4. tricyclic antidepressants , such as amitriptyline , which can reduce itch sensations in the skin 

5. anti inflammatory agents such as methotrexate 

6. behavioural therapy to reduce skin picking 

Pictures of ance urticata :







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