17-year-old patient with acne fulminans

In the present case, a complex interplay between inflammatory and infectious processes was found. The close temporal relationship between the dose increase of isotretinoin and the onset of symptoms suggests that this medication was a trigger. The simultaneous occurrence of paronychia and cellulitis complicated the clinical picture and emphasizes the need to distinguish between a superimposed (staphylococcal) infection and the spread of inflammation in the context of acne fulminans.