Granulomatous Facial Dermatoses

Dark perifollicular macules and granulomatous rosacea secondary to vandetanib

“…It may be a histological variant of acne rosacea and look acneiform clinically. 6,7 It likely arises through EGFR inhibition and an inflammatory response secondary to follicular obstruction, increased keratinocyte chemokine expression, and reduction in interleukin-1 decoy receptor expression. 5,6 The mainstay of management for photosensitivity and hyperpigmentation in such patients is strict photoprotection.…”

“…Granulomatous rosacea has a predilection for the face and histologically is characterized by a folliculocentric and vasculocentric infiltrate of lymphocytes, histiocytes, plasma cells and multinucleated giant cells, sometimes with non‐caseating granulomas, and superficial dermal telangiectasia. It may be a histological variant of acne rosacea and look acneiform clinically 6,7 . It likely arises through EGFR inhibition and an inflammatory response secondary to follicular obstruction, increased keratinocyte chemokine expression, and reduction in interleukin‐1 decoy receptor expression 5,6 …”

Uncommon Petaloid Form of Seborrheic Dermatitis Seen In Fitzpatrick Skin Types V-VI

“…Lesions on the anterior chest and face tend to have a psoriasiform morphology in petaloid SD, making psoriasis a common mimicking diagnosis for petaloid SD in skin of color [1]. Annular facial dermatoses in Fitzpatrick skin type V-VI can also closely resemble lesions of secondary syphilis, although presence of lesions only on the face and not a widespread eruption including the palms and soles would be unusual [2,10]. Another interesting variant of SD presents similarly to cutaneous sarcoidosis and is more likely to be encountered in African American patients [11].…”