My fiance never had problems with acne as a teenager/young adult. He is now 47 and within the past year has developed what we think is adult acne. He has the beginning of liver cirrhosis (alcohol related) and for almost 2 years has been on lactulose and spironolactone (he quit taking them in the past 2 months). He did not start having a problem with facial acne until he started doing some tree surgeon work off and on; cutting tops out of trees or cutting them down and sawing the wood in pieces.
Most of the wood he has cut has been live or water oak; also some cherry. A lot of this wood has been covered in poison ivy/sumac or who knows what other kind of vines, fungi, etc. While cutting wood, of course he gets covered with sawdust and other "earthy" materials. He also has psoriasis and has gotten some areas on his upper arms that became worse after he began the tree work, somewhat cleared after he hadn't done any tree work for a bit and then flared up again after doing more tree work.
He has been a construction worker most of his life and exposed to all sorts of materials, dusts, chemicals, etc.
My question is whether his condition is truly adult acne or some other skin condition caused by his past work in the construction industry, the tree work or his liver condition or a combination of all of these.
He was seen by a dermatologist for his psoriasis and asked about his "acne" and was told, oh yes it's adult acne, but there were no skin tests done to confirm this. He was given calcipotriene cream and triamcinolone acetonide ointment for the psoriasis which seemed to help at first, but then after not using it for a short time, when restarting the treatment didn't seem to help. (Also, he had insurance at the time to help with the cost, now has none).