Re: New to forum/FD - Really confused.. New pictures today

Well accutane does have its risks and I agree that you should take it with caution. It is a personal decision on whether or not to take it. I am convinced this condition was brought on by the steroids. I'm not sure how much good a hormonal workup will do you at this point since you have discontinued the steroids, but it only requires a blood test to check for testosterone levels etc. Some people get pituitary malignancies that create massive spikes in their Growth Hormone levels and can cause these types of conditions. Disseciting cellulitis seems to be caused by hyperkeratinization of the hair follicle, particularly the outer root sheath. The follicle fills with keratin material and the clogging causes a rupture, and spilling of material into the epidermis causes a granulamotous reaction followed by secondary bacterial infection. This is why you have the deep nodules and sinuses, the material is actually ruptured into the skin. This is caused by an occluded follicle thus the follicular occlusion triad I mentioned earlier. Hormones play a part in that androgens upregulate the keratinization of the follicle. Isotretinoin works in that it blocks this hyper keratinizing effect and normalizes it. Maybe you could try a topical retinoid instead of the isotretinoin (oral retinoid) as these have been shown to be quite effective. Acne in itself is a process of similar effect. Hyperkeratinization creates a plug and sebum build up allows bacteria to overgrow. Both events are hormonally influenced. Anyhow, it may be that you have some sort of hormonal imbalance that could indeed be corrected. Tweet