Childhood granulomatous periorificial dermatitis

A rare skin condition affecting children

Childhood granulomatous periorificial dermatitis (CGPD) is a rare dermatological condition that primarily affects children. It is characterized by the presence of papular eruptions around the orifices of the face, such as the mouth, nose, and eyes. This condition is also known as facial Afro-Caribbean childhood eruption (FACE) due to its higher prevalence in children of African descent.

Clinical Presentation

CGPD typically presents as small, flesh-colored to erythematous papules that are symmetrically distributed around the periorificial areas of the face. These papules may coalesce to form plaques. The condition is usually asymptomatic, although some patients may experience mild itching or burning sensations.

Etiology

The exact cause of CGPD is unknown. However, it is believed to be a variant of perioral dermatitis, with potential contributing factors including the use of topical corticosteroids, exposure to certain environmental factors, and genetic predisposition. The condition is more commonly observed in children with darker skin types.

Diagnosis

The diagnosis of CGPD is primarily clinical, based on the characteristic appearance and distribution of the lesions. A skin biopsy may be performed to confirm the diagnosis, revealing granulomatous inflammation in the dermis. Differential diagnoses include sarcoidosis, lupus miliaris disseminatus faciei, and granulomatous rosacea.

Management

Treatment of CGPD involves the discontinuation of any topical corticosteroids and the use of topical or oral antibiotics, such as metronidazole or erythromycin. In some cases, topical calcineurin inhibitors like tacrolimus may be effective. The condition often resolves spontaneously over time, but treatment can help accelerate the resolution of lesions.

Prognosis

The prognosis for CGPD is generally good, with most cases resolving without significant scarring or complications. However, the condition may persist for several months to years before complete resolution.

Related Pages

• Perioral dermatitis
• Granulomatous diseases
• Dermatology