scholarly journals Granuloma Faciale – A Difficult Diagnosis? – A Case Report / Facijalni granulom – da li ga je teško dijagnostikovati? – Prikaz slučaja

2012 ◽  
Vol 4 (1) ◽  
pp. 32-38
Author(s):  
Suzana Nikolovska ◽  
Đorđi Gocev ◽  
Katerina Damevska
Keyword(s):  
Leukocytoclastic Vasculitis ◽  
Pyogenic Granuloma ◽  
Topical Steroids ◽  
Eosinophilic Infiltrate ◽  
Biopsy Specimens ◽  
Discontinuation Of Treatment ◽  
Granuloma Faciale ◽  
The Face ◽  
Inflammatory Skin Disorder ◽  
Localized Form

Abstract Granuloma faciale is an uncommon inflammatory skin disorder clinically characterized by single or multiple, reddishbrown nodules or plaques primarily occurring on the face of middle-aged men. Occasionally, extra-facial involvement has been reported, usually on sun-exposed areas. Although the etiology is somewhat unclear, granuloma faciale is considered a localized form of chronic leukocytoclastic vasculitis with a prominent eosinophilic infiltrate and fibrosis in the later stages of the disease. Histological examination of lesions reveals a dense polymorphous inflammatory infiltrate that consists mainly of eosinophils and neutrophils separated from the epidermis by a narrow band zone with normal collagen, deprived of cells. Leukocytoclastic vasculitis is often seen. Clinical diagnosis is suspected in few cases, so definite diagnosis of granuloma faciale requires a biopsy. The disease is notoriously resistant to many therapies and often tends to relapse after treatment is discontinued. We present a female patient with granuloma faciale on the back and on the tip of the nose, misdiagnosed clinically as basall cell carcinoma and granuloma annulare. Her original histological diagnosis, made by a pathologist, was pyogenic granuloma. After revision of histologic findings of the biopsy specimens, granuloma faciale was diagnosed by a dermatopathologist. The treatment with cryotherapy and topical steroids was unsuccessful. Improvement of lesions was observed after use of tacrolimus 0.1% ointment, but lesion recurred after discontinuation of treatment.

scholarly journals Successful treatment of granuloma faciale

2020 ◽  
Vol 7 (1) ◽  
pp. 129
Author(s):  
Sahar H. Alsharif ◽  
Reda H. Saifaldeen ◽  
Logain G. Alghanemi
Keyword(s):  
Successful Treatment ◽  
Topical Steroids ◽  
Erythematous Plaque ◽  
Gradual Improvement ◽  
Topical Tacrolimus ◽  
Therapeutic Modalities ◽  
Granuloma Faciale ◽  
The Face ◽  
History Of

<p class="abstract">Granuloma faciale (GF) is a chronic condition characterized by asymptomatic erythematous plaque with prominent telangiectasia presenting usually over the face. Although the condition is benign, its treatment is often unsatisfactory. Therapeutic modalities that have been tried include topical steroids and topical tacrolimus sometimes enhanced with topical dapsone. Others include intralesional corticosteroids, antimalarials, isoniazid and pulsed-dye laser. We report a case of a 58 years old female with a 1 year history of a solitary slowly progressive plaque over the nose. Diagnosis of GF was made based on the histopathological findings. The patient was started on the combination of topical tacrolimus, intralesional corticosteroids injection and oral doxycycline for 3 months. The patient showed gradual improvement in 3 months without any side effects. This case supports previous papers of successful treatment of GF with topical tacrolimus. There was no recurrence at follow-up 18 months later. It also supports the use of combination therapy especially in resistant cases.</p>

Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany

2021 ◽  
Author(s):  
Sonja Heinzelmann ◽  
Daniel Böhringer ◽  
Philip Christian Maier ◽  
Berthold Seitz ◽  
Claus Cursiefen ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Treatment Strategies ◽  
Cost Benefit ◽  
Topical Steroids ◽  
Evidence Based ◽  
Systematic Analysis ◽  
Open Questions ◽  
The Face

Abstract Background Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection. Suture removal is a known risk factor for graft rejection. Nevertheless, there is no evidence-based regimen for rejection prophylaxis following suture removal. Therefore, a survey of rejection prophylaxis was conducted at 7 German keratoplasty centres. Objective The aim of the study was documentation of the variability of medicinal aftercare following suture removal in Germany. Methods Seven German keratoplasty centres with the highest numbers for PK were selected. The centres were sent a survey consisting of half-open questions. The centres performed a mean of 140 PK in 2018. The return rate was 100%. The findings were tabulated. Results All centres perform a double-running cross-stitch suture for standard PK, as well as a treatment for rejection prophylaxis with topical steroids after suture removal. There are differences in intensity (1 – 5 times daily) and tapering (2 – 20 weeks) of the topical steroids following suture removal. Two centres additionally use systemic steroids for a few days. Discussion Rejection prophylaxis following PK is currently poorly standardised and not evidence-based. All included centres perform medical aftercare following suture removal. It is assumed that different treatment strategies show different cost-benefit ratios. In the face of the diversity, a systematic analysis is required to develop an optimised regimen for all patients.

Tinea of the face caused by Trichophyton rubrum with histologic changes of granuloma faciale

1988 ◽  
Vol 18 (2) ◽  
pp. 403-406 ◽  
Author(s):  
David H. Frankel ◽  
Keyoumars Soltani ◽  
Maria M. Medenica ◽  
John W. Rippon
Keyword(s):  
Trichophyton Rubrum ◽  
Granuloma Faciale ◽  
The Face ◽  
Histologic Changes

scholarly journals Necrotizing leukocytoclastic vasculitis mimicking necrotizing fasciitis: a case report

2016 ◽  
Vol 2 (3) ◽  
pp. 193
Author(s):  
Mehmet Salih Soylemez ◽  
Korhan Ozkan ◽  
Bulent Kılıc ◽  
Samet Erinc ◽  
Irfan Esenkaya ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Laboratory Test ◽  
Necrotizing Fasciitis ◽  
Immunofluorescence Microscopy ◽  
Leukocytoclastic Vasculitis ◽  
Maculopapular Rash ◽  
Skin Manifestation ◽  
Biopsy Specimens ◽  
Common Skin

<p>There are several subtypes of necrotizing leukocytoclastic vasculitis, which are classified according to their morphological features in biopsy specimens using immunofluorescence microscopy. Necrotizing leukocytoclastic vasculitis is limited to the skin, predominantly that of the lower extremities, and usually spares the palms and soles. The most common skin manifestation is palpable purpura. Other skin manifestations include maculopapular rash, bullae, papules, nodules, ulcers and livedo reticularis. There is no specific laboratory test to determine the diagnosis. There are various diseases presenting with these nonspecific symptoms, and a rapid differential diagnosis must be conducted, because the appropriate differentiation and diagnosis markedly influence the treatment strategy and survival of patients. In this study, we report a case of necrotizing leukocytoclastic vasculitis<strong> </strong>presenting with internal organ involvement and symptoms of necrotizing fasciitis, with emphasis on the clinical differentiation.</p>

Inherited Deficiency of the Third Component of Complement Associated with Recurrent Pyogenic Infections, Circulating Immune Complexes, and Vasculitis in a Dutch Family

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 81-87
Author(s):  
John J. Roord ◽  
Mohamed Daha ◽  
Wietse Kuis ◽  
Henri A. Verbrugh ◽  
Jan Verhoef ◽  
...  
Keyword(s):  
Immune Complexes ◽  
Bacterial Infections ◽  
Leukocytoclastic Vasculitis ◽  
Skin Lesions ◽  
The Other ◽  
The Third ◽  
Biopsy Specimens ◽  
Recurrent Pyogenic Infections ◽  
Dutch Family ◽  
Third Component Of Complement

A family is described in which 3/11 children showed a homozygous deficiency of C3, and both parents and six other children had subnormal levels of C3. The three children with selective C3 deficiency suffered repeatedly from bacterial infections, whereas the parents and the other siblings were clinically healthy. During infectious episodes the patients showed a maculopapular skin rash, and at such times immune complexes were present in the serum. Biopsy specimens of the skin lesions showed the picture of leukocytoclastic vasculitis.

INCIDENCE OF CATARACT IN DERMATOLOGICAL PATIENTS USING STEROID CREAMS

2021 ◽  
pp. 65-66
Author(s):  
(Lt Col) Rajnish Kumar ◽  
(Lt Col) Vaka Raja Sekhar Reddy ◽  
(Lt Col) Sumit Kumar Singh ◽  
Debarshi jana
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Population Based ◽  
Topical Steroids ◽  
Study Group ◽  
Care Hospital ◽  
Ocular Side ◽  
Wide Range ◽  
The Face

Background/ Context: Corticosteroids, despite being a very effective line of treatment for various disorders is known to have a wide range of adverse effects. The use of systemic and topical steroids has been associated with cataract formation, however the ophthalmic side effects of application of steroid on skin away from the face has not been studied in depth. With increasing use of corticosteroids as rst line of therapy in treatment of various dermatological conditions, the ocular side effects, if any, of these preparations, cannot be overlooked. Aim: To study the incidence of cataract in patients using skin preparations of corticosteroids away from the face and also to correlate the dose and duration of steroid therapy to incidence of cataract. Materials & Methods: 50 patients with dermatological disorders who were being treated with dermatological steroids, on sites other than the face and periorbital region, for a period of more than six months consisted of the study group. The study group consisted of patients in the age group of 20 – 60 years. The study was conducted over a period of two years at a tertiary care hospital. Visual acuity, Slit lamp biomicroscopy, applanation tonometryand detailed fundus examination using 90D lens were carried out. Results: The incidence of cataract was signicantly higher in patients using dermatological steroids away from the face. Prolonged duration of use of these steroids also indicated a signicantly higher incidence of cataract. However, a larger population based study needs to be carried out to study the relationship between potency of steroid and incidence of cataract, although preliminary studies indicate a denite correlation between the two. Conclusions: Despite, steroids being used away from the face, there was a denite increase in the incidence of cataract. Before coming to any rm conclusions it would be advisable to reproduce the study in a larger population. However from the present pilot study it is prudent to advocate judicious use of innocuous looking steroid creams as they can cause signicant adverse effects

scholarly journals Face and Neck Dermatitis from a Stainless Steel Orthodontic Appliance

2009 ◽  
Vol 79 (6) ◽  
pp. 1194-1196 ◽  
Author(s):  
Minna Ehrnrooth ◽  
Heidi Kerosuo
Keyword(s):  
Adverse Reactions ◽  
Contact Allergy ◽  
Orthodontic Appliances ◽  
Maxillary Expansion ◽  
Orthodontic Appliance ◽  
Nickel Allergy ◽  
Discontinuation Of Treatment ◽  
Patient Reported ◽  
The Face ◽  
Adult Female Patient

Abstract Although nickel is the most common cause of contact allergy, nickel-containing orthodontic appliances seldom cause adverse reactions that result in discontinuation of treatment. We report on an eruption of dermatitis in the face and neck of an adult female patient after placement of a rapid maxillary expansion appliance (RME). Because the patient suspected nickel allergy, her tolerance to the appliance material was tested intraorally before treatment by cementing bands on four teeth for a week. No visible adverse reactions were seen during the test. One week after cementation of the RME appliance, the patient reported strong itching of the face and a red rash. Clinical examination showed itchy papular erythema on the face and neck. No intraoral reactions or symptoms were present. The RME appliance was removed, and symptoms disappeared in 4 to 5 days. The patient was referred for a nickel patch test, which gave a strong positive result. Adverse patient reactions of potential allergic origin should be diagnosed carefully, and their possible impact on further treatment should be evaluated accordingly.

scholarly journals Timolol for Treatment of Recalcitrant Pyogenic Granulomas: a Case Report and Review of the Literature

2017 ◽  
Vol 1 (3) ◽  
pp. 150-155
Author(s):  
Paige Hoyer ◽  
Priscilla Ly ◽  
Lindy Ross ◽  
Michael Wilkerson
Keyword(s):  
Current Literature ◽  
Treatment Options ◽  
Ophthalmic Solution ◽  
Pyogenic Granuloma ◽  
Vascular Tumor ◽  
Current Treatment ◽  
Multiple Form ◽  
The Face ◽  
Therapy Option ◽  
A Site

Importance: Pyogenic Granuloma (PG) is a benign vascular tumor that forms commonly on the face, oral mucosa, or a site of previous injury. Though some PGs resolve spontaneously, most require some-to-multiple form(s) of treatment to prevent bleeding, ulceration, and scarring. Current treatment options for PGs include cryotherapy, laser, electrodessication, curettage or shave excision, sclerotherapy, corticosteroid injections, and imiquimod 5% cream. Timolol 0.5% ophthalmic solution has been used as a noninvasive topical treatment for PG in the pediatric population.Objective: To present a case of successful treatment of a recalcitrant PG with topical timolol, and to report on the current literature for similar cases.Case Presentation: We present a case of a 40-year-old healthy female who developed a biopsy-proven PG on her index finger. This is the first reported case to successfully use tangential biopsy and electrodessication followed by twice daily topical Timolol to treat recalcitrant PG.Conclusions: This case supports the use of 0.5% Timolol ophthalmic solution and demonstrates that it is a safe and economical therapy for adult patients with recurrent PGs. A review of the current literature is discussed, and supports timolol as an easy and economical therapy option.

scholarly journals Over the counter medication: a study among dermatology outpatients

2019 ◽  
Vol 5 (3) ◽  
pp. 607
Author(s):  
Ramadevi Birudala ◽  
Shruthi Hassan Nagaraj ◽  
Kousar Begum Bannala ◽  
Vijayarangam ShivaKumar
Keyword(s):  
Task Force ◽  
Clinical Analysis ◽  
Topical Steroids ◽  
Fixed Drug Eruption ◽  
Over The Counter ◽  
The People ◽  
Counter Medication ◽  
Causative Agents ◽  
The Face ◽  
Cutaneous Drug Reactions

<p class="abstract"><strong>Background:</strong> Over-the-counter (OTC) medicine or non-prescription medicine refer to medicine that you can buy without a prescription from a health care professional. The prevalence, clinical patterns and causative agents of cutaneous drug reactions vary among different populations. The most widely used over the counter medication in dermatological practice are topical steroids. The main objective is to know awareness among the people about over the counter medication and clinical analysis of effects caused by them, to find the most commonly used OTC medication.</p><p class="abstract"><strong>Methods:</strong> Prospective questionnaire based study comprising of 453 cases of cutaneous effects due to over the counter medication was carried out for a period of 1 year. Diagnosis was made mainly based on clinical features.<strong></strong></p><p class="abstract"><strong>Results:</strong> Super potent and high potent steroids were the most common OTC medication used which caused nodulocystic acne in 51.6% patients, atrophy in 3.97% patients, tinea incognito in 23.8% patients. Irritant contact dermatitis (due to hydroquinone, cotrimoxazole, neomycin) was seen in 18.5% patients. Fixed drug eruption was seen in 1.32% patients, cushingoid features in 0.66% patient.</p><p class="abstract"><strong>Conclusions:</strong> Indiscriminate abuse of steroids by people due to lack of awareness should be stopped. This misuse and damage have serious effect on the quality of life of the patients in general and the skin of the face in particular. Management is difficult and necessitates psychological counselling as well as physical soothing of the sensitive skin. For the safety of people Indian association of Dermatology, Venereology and Leprology (IADVL) also started IADVL Task force Against Topical Steriod Abuse (ITATSA).</p>

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