Introduction

 Inverse acne (IA) is a chronic inflammatory skin disease that is more common in women, especially during puberty and menopause. It is believed that the first link of the pathogenetic mechanism is hyperkeratinization of the follicular cavity, followed by follicular occlusion, followed by expansion and rupture, and the presence of bacterial agents in the focus leads to the development of a local inflammatory reaction. Many concomitant diseases and triggers have been identified, including bacterial flora, which can significantly complicate the course of IA, lead to the chronization of the disease and a poor response to therapy. Early diagnosis of IA leads to the timely appointment of treatment. The diagnosis of IA is based on clinical features, and depending on the stage of severity according to Hurley, it is very important to choose the appropriate treatment. 

Case presentation

The authors present a clinical case of IA complicated by actinomycosis and viral hepatitis C.

Conclusion

 Actinomycosis is currently a rare diagnosis, especially in developed countries. In clinical practice, the diagnosis of actinomycosis can be difficult due to the nonspecific clinical and pathological features of the pathogen, its inherent difficulties in in vitro cultivation and complex histological characteristics. However, given the growing number of immunocompromised patients worldwide (for example, HIV-infected or hepatitis C patients) and numerous reports of infection with actinomycetes in these conditions, actinomycosis should be considered as a possible opportunistic infection.