Serratia pyoderma mimicking acne vulgaris

A 17-year-old woman with no significant medical history presented complaining of acne. She reported that three days before her "acne" started she applied tea tree oil (TTO) for a few pimples. Photos on the patient's phone before TTO application revealed completely clear facial skin. Within a few days of TTO use she developed a facial eruption. She was evaluated by her pediatrician who prescribed minocycline for 10 days along with adapalene and benzoyl peroxide. She did not improve and was referred to dermatology.