Abstract
Pyodermite froide du visage, otherwise known as idiopathic facial aseptic granuloma (IFAG), is a benign lesion exclusively seen in children and presents as a cold abscess on the face.1 We report a case of a 14-year-old male with IFAG who failed initial treatment with oral doxycycline, but responded to treatment with oral 13-cis-retinoic acid, oral trimethoprim-sulfamethoxazole and intralesional triamcinolone injections over a 7 month period.
Highlights
Idiopathic facial aseptic granuloma (IFAG) or pyodermite froide du visage is seen exclusively in children.[1]
Treatment was initiated with oral 13-cis-retinoic acid 40 mg twice daily, oral azithromycin 250 mg daily for 6 days, and topical clindamycin 1% solution. 1 cc of intralesional triamcinolone (10 mg/cc) was injected every other month for 12 months
Two theories have been promulgated to explain the pathogenesis of IFAG
Summary
Idiopathic facial aseptic granuloma (IFAG) or pyodermite froide du visage is seen exclusively in children.[1] It presents as an erythematous to violaceous nodule or plaque most commonly seen on the checks or eyelids.[2] This condition most often presents as a single lesion within a triangle-shaped area delineated by the external limit of the orbit, the labial angle, and the ear lobe.[6]. Lesions tend to resolve spontaneously with minimal scarring within a few months to a year.[2] There are no risk factors that predispose an individual to developing IFAG.[4]
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