Drug-induced acne with elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis

•Some patients report new or worsening acne after starting elexacaftor/tezacaftor/ivacaftor.•The immunologic basis of this adverse effect is unclear.•Treatment may require trial and error with combination topical therapies or systemic therapies. Elexacaftor/tezacaftor/ivacaftor (ELX-TEZ-IVA) is a Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulator shown to improve lung function and reduce sweat chloride in people with Cystic Fibrosis (CF). The only commonly reported dermatologic adverse effect with CFTR modulators including ELX-TEZ-IVA is rash. In this case series, we describe 19 patients who reported new onset or worsening of acne after initiation of this drug to their CF pharmacist or another member of their CF care team. The mechanism and frequency of this adverse effect is unknown.