A 19yr old boy with multiple boils over the face, back , chest, arms b/l and lateral aspect of thighs since 5yrs..itching present..kindly opine on diagnosis and treatment



It is advisable to send a biopsy of this case for HPE as this case seems to be tricky and needs to be worked upon. Could be a severe form of acne vulgaris but could be something like hidradenitis suppurativa as well. Hard to comment upon without looking at the biopsy. His viral markers may be done at first and then a course of antibiotics ( Doxycycline) and Isotretinion may be given to see if positive results are obtained along with topical clindamycin/benzoyl peroxide.

Appears severe acne vulgaris with comedones, papules, pustules & cysts. Maybe pt. Is having oily skin so predisposed to acne. Look to his occupation & hobbies. If he is exposed to oil / petroleum derivatives or halogen related chemicals or compounds. See if he has Diabetes? Is he Hiv + ? Is he suffering from congenital immunodeficiency syndromes? Also the Purulent discharge should be sent for culture and sensitivity. As a last resort, biopsy of the lesion & histopathology examination should be done.

Acne vulgaris can be on face, neck and back but not on lower back and legs.scabies usually not on face.refractory resistant pyoderma with viten b12 deficiency.c/s proper antibiotic with b12 supplements will help healing.

Acne Vulgaris

Acne vulgaris

It is not boil; Severe Acne vulgaris. This type of patients often suffers from Dandruff. Homeopathy gives miraculous result in these types of case. Though selection of medicine depends on extensive case taking you can prescribe SULPHAR 6, 1 dose and wait for 1 month

DD Extensive acne vulgaris Prurigo nodularis Needs biopsy, pus culture, blood culture, viral hepatitis profile ,abdominal ultrasound

Acnitic hyperpigmentation dd acne dd folliculitis dd impetigo


Such cases generally respond to anti-acne treatment.acne lesions do occur on the back of trunk though not common. Scabies lasting for years is also seen and responds to ordinary treatment.

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