Successful treatment of facial papules with electrodessication in a patient with birt-hogg-dubé syndrome

Abstract

We report a case of a 51-year-old Hispanic woman who presented with a several year history of multiple flesh colored papules of cosmetic concern on the nose and medial cheeks (Figure 1). Biopsies revealed fibrofolliculoma and trichodiscoma. The patient was referred for genetic testing and was found to be positive for the FLCN gene defect, confirming a diagnosis of Birt-Hogg-Dubé syndrome. Further work-up with screening renal ultrasound and CT scan of the thorax and abdomen was unrevealing. For treatment of these skin lesions, dermasanding was attempted initially with only minimal benefit. She subsequently had multiple lesions treated with hyfrecation (also known as electrodessication or cautery) at a low setting and was very pleased with the results (Figure 2). Importantly, there has yet to be a recurrence of lesions two years status-post hyfrecation.