2025 Clinician Corner - Vitamin B12-induced acneiform eruption
Abstract
Cutaneous acneiform eruptions are a side effect of many medications, including vitamin B12 therapy. However, reports of vitamin B12–induced acne are rare. We present a 67-year-old woman with a new diagnosis of pernicious anemia who developed a sudden acneiform eruption on the face after treatment with high-dose vitamin B12. Other medications that have been implicated in drug-induced acne include but are not limited to steroids, antibiotics, immunosuppressants, biologics, and vitamin B1 and B6. The pathogenesis is likely due to a transcriptome change in Propionibacterum acnes, the organism responsible for acne vulgaris. Cessation of the offending agent leads to a regression in symptoms.
Keywords: Acne vulgaris; drug-induced acne; vitamin B12
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Faculty credentials/disclosure
The planners and faculty for this activity have no relevant financial relationships to disclose. The patient consented to the publication of this report.
Process
Click the "add to cart/begin" button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit. You must achieve 100% on the quiz with unlimited attempts available.
- By completing this process, you are attesting that you have read the journal article.
Expiration date:
Credit eligibility for this article is set to expire on January 1, 2026.
Learning Objectives
After completing the article, the learner should be able to:
Identify the differences between acne vulgaris and drug-induced acne.
Identify common causes of drug-induced acne.
Differentiate between correct treatments and recognize that the correct treatment for drug-induced acne is most often cessation of the offending drug.
Key points
Several medications have been implicated in causing drug-induced acne, including steroids, oral contraceptives, and vitamin B12.
First-line treatment of drug-induced acne is cessation of the drug.
The pathogenesis likely involves upregulated porphyrins, which increase inflammation.
Differences between drug-induced acne and acne vulgaris include the absence of comedones and cysts.
Jacob J. Owen, BA, Texas A&M School of Medicine, Dallas, Texas, USA
Ronnie M. Youssef, MD, Department of Dermatology, Baylor Scott & White Medical Center – Temple, Temple, Texas, USA
Kirstin Altman, MD , Department of Dermatology, Baylor Scott & White Medical Center – Temple, Temple, Texas, USA
Accreditation
The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation
AMA PRA Category 1 Credit™
The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABS CC
Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
ABIM MOC
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
Available Credit
- 1.00 AMA PRA Category 1 Credit™The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
- 1.00 Attendance