PubMed · 16310094
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Samuel Selden. 2005. Pyoderma faciale.. https://doi.org/10.1016/j.jaad.2005.08.030
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54-year-old woman presented with an unusual presentation of chronic cutaneous lupus erythematosus that mimicked pseudoxanthoma elasticum. The lesions were asymptomatic, 2-3 mm, skin-colored, smooth papules without scale or erythema; they were located on the chin, medial malar cheeks, and upper lip. She previously failed traditional treatments, which included hydroxychloroquine and dapsone. The patient responded to thalidomide with a reduction in appearance and number of lesions.
We describe a 58-year-old woman with a 4-year history of papular lesions with a partly verruciform appearance on the eyelids and the adjacent areas of the nose. The lesions progressed slowly but constantly into the surrounding areas with central scarring. Histopathology showed epidermal endophytic proliferations under a pronounced hyperparakeratosis. In the adjacent dermis a lymphohistiocytic infiltrate with giant cells of the foreign-body-reaction type was seen in close contact to extracellular keratin deposits. Although some cytopathological signs typical for viropathic effects were observed, no human papilloma virus-DNA was detected within the lesions by polymerase chain reaction. According to the histological picture and the clinical course we diagnosed a keratoacanthoma centrifugum marginatum. We present this case because of the strong granulomatous foreign body reaction which might complicate the diagnosis and has not been described for this keratoacanthoma variant so far.
Recently, a dual-wavelength 532/940-nm laser has become available for treatment of facial vascular lesions as an alternative to the flashlamp pumped-dye lasers. Most facial vascular lesions will respond to the 532-nm wavelength. However, some of the larger and deeper lesions are resistant to this laser. The 940-nm wavelength can be used to treat these resistant lesions. Sixteen patients with 532-nm laser-resistant vascular lesions were treated with the 940-nm laser. Fourteen of these 16 patients had improvement in their telangiectasia in response to these treatments. Most facial l telangiectasias respond well to treatment with the 532-nm laser. However, some of the larger and deeper lesions will not respond well to this laser. The 940-nm wavelength laser can be used to treat these 532-nm laser resistant lesions.