Inflammatory cystic acne on the face of a young woman.

• A. Acne fulminans
• B. Pyoderma Faciale
• C. Acne vulgaris
• D. Rosacea

Answer: (B)

This presentation is best explained by Pyoderma faciale, a distinct, severe inflammatory eruption that can mimic acne but occurs abruptly in women of reproductive age. It typically shows rapid-onset, painful nodules and cysts on the central face and often lacks the comedones that characterize typical acne vulgaris. This helps separate it from acne vulgaris, which is usually more common, evolves gradually, and includes comedones. Acne fulminans, by contrast, tends to occur in adolescent males and includes systemic symptoms like fever and malaise. Rosacea involves facial redness, flushing, and telangiectasia, with papulopustular components but not the same abrupt, cystic, acne-like presentation. So the features described fit Pyoderma faciale.