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CES Medicina
Print version ISSN 0120-8705
Abstract
ZULUAGA-SEPULVEDA, MARÍA ALEJANDRA; JIMENEZ-TAMAYO, SOL BEATRIZ and RUIZ, ANA CRISTINA. Minocycline in the treatment of periorificial granulomatous dermatitis in a white child without response to other tetracyclines. CES Med. [online]. 2013, vol.27, n.2, pp.219-225. ISSN 0120-8705.
Periorificial granulomatous dermatitis is a rare entity that was first reported in black children. Because of this, it was called facial afro-caribbean childhood eruption. However, in later publications it was found that this disease can occur in people of all races. Chronic use of topical steroids is the major exacerbating factor and the suspension of these is the cornerstone of treatment. We report the case of a 14 year-old boy with 8 months of well-defined erythematous papules located on his lower eyelids and nasolabial folds with surrounding erythema and desquamation. He was treated with deflazacort, medrol, high potency topical steroids, dapsone, and oral isotretinoin, with little improvement. Skin biopsy reported noncaseating granulomas composed of epithelioid macrophages and lymphocytic inflammatory infiltrate. The diagnosis of periorificial granulomatous dermatitis was made based on clinical history, physical examination and histology. Management was initiated with oral minocycline and topical tacrolimus, with almost complete disappearance of lesions after a month and a half of treatment.
Keywords : Perioral; Granulomatous; Steroids; Minocicline.