Idiopathic aseptic facial granuloma: A retrospective study of 43 cases.

BACKGROUND: Idiopathic aseptic facial granuloma (IAFG) is an underrecognized pediatric skin disease, currently considered within the spectrum of rosacea. It usually manifests as a solitary, reddish, asymptomatic nodule on the cheek that resolves spontaneously. METHODS: Retrospective and descriptive observational study of 43 pediatric patients with a clinical diagnosis of IAFG, followed between 2004 and 2022, at two general hospitals in Argentina. RESULTS: IAFG predominated in girls (65%) and the average age of onset was about 6 years. A single asymptomatic nodule was seen in 79% of patients. The most common localization was the cheek (58%) followed by lower eyelids (41%). Family history of rosacea was present in 16% of patients. A concomitant diagnosis of rosacea and periorificial dermatitis was made in 14% and 9% of our population, respectively. Past or present history of chalazia was detected in 42% of the children. IAFG diagnosis was mainly clinical (88% of cases). Oral antibiotics were the most common indicated treatment (84%). Complete healing was achieved by the majority, but 18% of those with eyelid compromise healed with scars. CONCLUSIONS: IAFG is a benign pediatric condition that physicians should recognize in order to manage correctly. We herein refer to a particular morphologic aspect of IAFG lesions affecting the lower eyelids, where nodules adopt a linear distribution and have a higher probability of involute leaving a scar. Also, we consider that the concomitant findings of rosacea, periorificial dermatitis and chalazia in our patients, reinforce the consideration of IAFG within the spectrum of rosacea.

Idiopathic facial aseptic granuloma in children: Management and long-term follow-up.

AIMS: The primary objective was to study long-term outcomes in children with idiopathic facial aseptic granuloma (IFAG). The secondary objectives were to describe the clinical polymorphism of this entity, the different therapeutic options, and the occurrence of rosacea in this population. METHODS: We selected patients with a clinical diagnosis of IFAG seen in two different hospitals in Normandy between March 2016 and February 2021, and we collected clinical and therapeutic data from computerized medical records. A remote consultation based on recent photographs was performed to collect new data, and the children's parents were asked to complete a questionnaire between February and August 2021. RESULTS: Ten children were included in this study. Nine patients presented with a single red to purplish nodule. One patient presented multiple papulopustular plaques. IFAG healed spontaneously without major sequelae, and this outcome was not influenced by any treatments. During follow-up, two patients developed childhood rosacea. CONCLUSION: Although some clinical heterogeneity exists, early diagnosis and follow-up of IFAG is necessary to avoid unnecessary topical or systemic antibiotic treatments that do not shorten the disease course. IFAG appears to be a possible mode of entry for infantile rosacea.

Ultrasound findings in idiopathic facial aseptic granuloma: Case series and literature review.

Idiopathic facial aseptic granuloma is an inflammatory nodule commonly located on the cheeks and eyelids in young children. Despite its prolonged course, it tends toward spontaneous resolution, so invasive diagnostic procedures should be avoided. Cutaneous ultrasound is a noninvasive modality that has been found to improve the diagnostic accuracy of nodular skin lesions. We report five children with idiopathic facial aseptic granuloma in whom high-resolution ultrasound examination provided distinctive findings.

Idiopathic facial aseptic granuloma-A diagnostic challenge in pediatric dermatology.

Idiopathic facial aseptic granuloma is a distinct, benign lesion that presents in very young children and is characterized by a painless facial nodule that usually appears on the cheek. It is typically characterized by a prolonged course but heals spontaneously or in response to antibiotic treatment. The challenge is to diagnose this entity correctly, ideally based on clinical acumen, to avoid surgical intervention with facial sutures and the resultant scarring and unnecessary treatment interventions. In this article, we discuss three cases of idiopathic facial aseptic granuloma to raise awareness and highlight the diagnostic challenges and possible link to childhood rosacea.

Granuloma aséptico facial idiopático / Idiopathic facial aseptic granuloma

Idiopathic facial aseptic granuloma (IFAG) is characterized by the appearance of a painless reddish nodule in the facial region and is exclusive to children. It is usually located on the cheek. The resolution of these lesions is usually spontaneous in months and they heal without leaving a scar or with minimal scarring. Its etiology is unknown. The diagnosis is fundamentally clinical, although sometimes complementary tests such as ultrasound can be used. This pathology presents a chronic but benign clinical course with spontaneous resolution, so in these cases a wait-and-see approach is preferred (AU)

Idiopathic facial aseptic granuloma (IFAG) is characterized by the appearance of a painless reddish nodule in the facial region and is exclusive to children. It is usually located on the cheek. The resolution of these lesions is usually spontaneous in months and they heal without leaving a scar or with minimal scarring. Its etiology is unknown. The diagnosis is fundamentally clinical, although sometimes complementary tests such as ultrasound can be used. This pathology presents a chronic but benign clinical course with spontaneous resolution, so in these cases a wait-and-see attitude is preferred. (AU)

Idiopathic Facial Aseptic Granuloma in a 13-Year-Old Boy Dramatically Improved with Oral Doxycycline and Topical Metronidazole: Evidence for a Link with Childhood Rosacea.

Idiopathic facial aseptic granuloma (IFAG) is a rare, benign pediatric dermatological lesion that occurs in children between 8 months and 13 years of age. The pathogenesis of IFAG is still unclear but it is likely to be associated with granulomatous rosacea in childhood. Here we describe a case of IFAG in a 13-year-old boy who showed a dramatic response to oral doxycycline and topical metronidazole, which supports the hypothesis that IFAG may belong to the spectrum of rosacea.