
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.
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

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