Diagnosis: Granulomatous periorificial dermatitis.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Histologic examination revealed a basket-weave orthokeratosis overlying a normal epidermis, and there were several poorly formed granulomas containing numerous lymphocytes, neutrophils, histiocytes, and occasional giant cells found mainly within the superficial dermis in a perifollicular distribution.
At the initial visit, our patient was started on a twice-daily regimen of topical 0.75% metronidazole gel. At the follow-up visit 1 month later, the rash had worsened, with new periorbital involvement. Combination therapy with the topical metronidazole and oral doxycycline (100 mg twice a day) was initiated. One week later, the patient reported improvement of the eruption and was asymptomatic.
DISCUSSION
Granulomatous periorificial dermatitis is also known as facial Afro-Caribbean childhood eruption, Gianotti-type perioral dermatitis, sarcoidlike granulomatous dermatitis, and granulomatous perioral dermatitis. It is a relatively uncommon, distinctive facial eruption characterized by grouped, monomorphic, flesh-colored to yellow-brown papules that are usually found in perioral, periocular, and perinasal regions. The condition is often asymptomatic but . . . [Full Text of this Article]
