Chronic superficial pyoderma of the face: an unusual male case of rosacea fulminans.
A 62-year-old Japanese male developed acneiform papules on the face in November of 2002. The eruptions progressed to exudative erythema with central necrosis, and then to thick-crusted superficial abscesses in a short period. The shallow ulcers exposed by removal of the crusts and abscesses immediately re-epithelized without leaving scars. The histology of the eruption was a dense infiltration of neutrophils associated with granulomatous changes in the upper to middle dermis. Histology of the tiny white particles in the abscess showed an irregularly proliferated mass of keratinocytes including accumulated neutrophils. The skin lesions resisted intravenous injection of antibiotics but responded to systemic administration of a corticosteroid agent. Colchicine did not work well, but the additional administration of etretinate was effective. The patient is currently receiving combined therapy with prednisolone and etretinate, but eruptions are still episodically observed. We diagnosed this case as an unusual male case of rosacea fulminans.
Mori
Ryoko
R
Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan.
Matsushima
Satoko
S
Honda
Tetsuya
T
Horiguchi
Yuji
Y
Imamura
Sadao
S
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005148:Facial Dermatoses / Q000175:diagnosis / Q000188:drug therapy; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008297:Male; D008875:Middle Aged; D011711:Pyoderma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D012008:Recurrence; D018570:Risk Assessment; D012393:Rosacea / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents