Granulomatous periorificial dermatitis: a variant of granulomatous rosacea in children?
BACKGROUND
We report a case of granulomatous periorificial dermatitis (GPD). A 13-year-old Jamaican boy presented with pink to flesh-colored perioral and periocular papules that erupted during a summer visit to Jamaica. The child was initially diagnosed with sarcoidosis and treated with oral corticosteroids, but the eruption recurred 2 years later. He was referred to Dermatology. Biopsy of one of the facial papules revealed a dense granulomatous infiltrate with surrounding prominent lymphocytes. A diagnosis of GPD was made.


CONCLUSIONS
Also known as facial Afro-Caribbean childhood eruption (FACE), GPD occurs in prepubertal children. It can be confused with sarcoidosis, infection, and granulomatous rosacea but contains lymphocytes around the granulomas and lacks the systemic involvement seen in sarcoidosis. Cultures are invariably negative. The histologic features of GPD and granulomatous rosacea can be identical, and certain treatments may exacerbate the condition, highlighting the importance of clinical correlation. The correct diagnosis is important to minimize treatment as GPD is ultimately self-limited.
Lucas
Chere R
CR
Department of Dermatology, University Hospital of Cleveland/Case Western Reserve University, Cleveland, OH, USA.
Korman
Neil J
NJ
Gilliam
Anita C
AC
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003872:Dermatitis / Q000473:pathology*; D003879:Dermatologic Agents / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004917:Erythromycin / Q000008:administration & dosage; D005145:Face; D006099:Granuloma / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008297:Male; D012393:Rosacea / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D017444:Skin Diseases, Papulosquamous / Q000188:drug therapy / Q000473:pathology*; D016559:Tacrolimus / Q000008:administration & dosage / Q000031:analogs & derivatives
D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D004917:Erythromycin; C117268:pimecrolimus; D016559:Tacrolimus