A Report of Two Cases of Solid Facial Edema in Acne.
BACKGROUND
Solid facial edema (SFE) is a rare complication of acne vulgaris. To examine the clinical features of acne patients with solid facial edema, and to give an overview on the outcome of previous topical and systemic treatments in the cases so far published.


METHODS
We report two cases from Switzerland, both young men with initially papulopustular acne resistant to topical retinoids.


RESULTS
Both cases responded to oral isotretinoin, in one case combined with oral steroids. Our cases show a strikingly similar clinical appearance to the cases described by Connelly and Winkelmann in 1985 (Connelly MG, Winkelmann RK. Solid facial edema as a complication of acne vulgaris. Arch Dermatol. 1985;121(1):87), as well as to cases of Morbihan's disease that occurs as a rare complication of rosacea.


CONCLUSIONS
Even 30 years after, the cause of the edema remains unknown. In two of the original four cases, a potential triggering factor was identified such as facial trauma or insect bites; however, our two patients did not report such occurrencies. The rare cases of solid facial edema in both acne and rosacea might hold the key to understanding the specific inflammatory pattern that creates both persisting inflammation and disturbed fluid homeostasis which can occur as a slightly different presentation in dermatomyositis, angioedema, Heerfordt's syndrome and other conditions.
University of Zurich, Zurich, Switzerland.
Sarah
S
Kuhn-Régnier
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Joanna
J
Mangana
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Katrin
K
Kerl
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Jivko
J
Kamarachev
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Lars E
LE
French
Department of Dermatology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
Antonio
A
Cozzio
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. alexander.navarini@usz.ch.
Alexander A
AA
Navarini
Adrenergic receptors; Brimonidine; Erythema; Rosacea; Vasoconstriction; Worsening of erythema