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Clofazimine in inflammatory facial dermatosis--granuloma faciale and lipogranulomatosis subcutanea (Rothmann-Makai)

Authors:
  • Städtisches Klinikum Dresden
... rituximab (Babalola, Zhang, Kristjansson, Whitaker-Worth, & McCusker, 2014;Bobyr et al., 2016;Dourmishev, Ouzounova-Raykova, Broshtilova, & Miteva, 2014;Jardim, Uchiyama, Kakizaki, & Valente, 2018;Lindhaus & Elsner, 2018;Micallef & Boffa, 2017;Morgado-Carrasco, Giavedoni, Mascaro Jr., & Iranzo, 2018;Ohata & Nakama, 2019;Santos-Alarcon et al., 2016;Shimoda-Komatsu, Kinoshita-Ise, Shimoyamada, & Ohyama, 2018;Wollina, Karte, Geyer, Stuhlert, & Bocker, 1996;Yuan et al., 2018). ...
... The disease can persist for months to years. The disease has been considered an afebrile variant of panniculitis nodularis nonsuppurativa febrilis et recidivans [1] or a subtype of Weber-Christian disease withour internal manifestations [2]. Due to its rareness there is ...
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The skin is the primary interface between the body and the environment. It is exposed to a variety of external physical factors to which it must respond in a dynamic manner. In the following review such cutaneous reactions to physical damage are discussed under the aspects of rheumatological differential diagnoses. In particular, circumscribed hyperpigmentation and hyperkeratosis, reactive patterns to cold, with or without humidity, and lightning are presented. Most of these disorders do not need extensive laboratory investigations or imaging techniques. Knowledge of such cutaneous disease symptoms due to physical damage prevents overdiagnostics and possible overtreatment.
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Granuloma faciale is an uncommon benign chronic dermatosis characterized by reddish-brown to violaceous asymptomatic plaques appearing predominantly on the face. The pathogenesis of granuloma faciale remains unclear, and it is frequently unresponsive to therapy. This systematic review aims to summarize all recent publications on the management of granuloma faciale. The publications are mainly individual case reports, small case series and a few retrospective studies. Treatment options included topical, intralesional and systemic corticosteroids, topical pimecrolimus and tacrolimus, topical and systemic dapsone, systemic hydroxychloroquine, clofazimine, and tumour necrosis factor-alpha inhibitors. More invasive therapies using lasers as well as cryosurgery and surgery were also reported. Topical glucocorticosteroids and tacrolimus remain treatments of first choice, possibly supplemented by topical dapsone.
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Full-text available
Granuloma faciale is an uncommon benign chronic dermatosis characterized by reddish-brown to violaceous asymptomatic plaques appearing predominantly on the face. The pathogenesis of granuloma faciale remains unclear, and it is frequently unresponsive to therapy. This systematic review aims to summarize all recent publications on the management of granuloma faciale. The publications are mainly individual case reports, small case series and a few retrospective studies. Treatment options included topical, intralesional and systemic corticosteroids, topical pimecrolimus and tacrolimus, topical and systemic dapsone, systemic hydroxychloroquine, clofazimine, and tumour necrosis factor-alpha inhibitors. More invasive therapies using lasers as well as cryosurgery and surgery were also reported. Topical glucocorticosteroids and tacrolimus remain treatments of first choice, possibly supplemented by topical dapsone.
Article
The case of a 43 year-old woman is presented. She had three erythematous plaques in her face, which were asymptomatic and chronic. She had had recurrent lesions after a surgical treatment. The granuloma faciale is rare, which is seen mainly on the face as erythematous plaques or nodes. Its evolution is persistent and chronic, but benign. Histologically, two phases have been identified: an initial or "leukocytical" and a late one or "fibrotic". In the latter, there's known to be presence of "leukocytoclastia" and an inflammatory infiltrate mixed with a predominance of polymorphonuclear leukocytes and eosinophils. Although there is not an effective treatment for this pathology, topical and intralesional steroids have been used and also oral dapsona and clofazimina, as well as a variety of lasers, yielding variable results on the short and long term.
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Clofazimine is the riminophenazine dye that, due to its antibacterial and anti-inflammatory properties, has been used for several diseases. This article reviews all major characteristics and uses relating to clofazimine, from its pharmacology to its indications in several skin diseases, over and above its classical and well established use in the treatment of leprosy. Due to its anti-inflammatory and antimicrobial properties, clofazimine has a wide spectrum for application in dermatology. The indications include neutrophilic, granulomatous and infectious diseases. Although it is not the first-choice medication in most of the cases, clofazimine should always be considered among the therapeutic options in refractory cases.
Article
Granuloma faciale, a rare, chronic, cutaneous disorder, is uncommon in children. Numerous treatment modalities have been used to treat granuloma faciale but none are consistently effective. In addition, many of the previously used therapies have unwanted side effects or are not well tolerated by children. We report a case of granuloma faciale in an 11-year-old child successfully treated with the pulsed dye laser. To our knowledge, this is the first report of this treatment modality for granuloma faciale.
Article
The term granuloma faciale was first coined by Pinkus² in 1952. Formerly, this rare cutaneous disorder had been called eosinophilic granuloma of the skin. While granuloma faciale has been reported in children and adult women,³ the typical patient is a middle-aged white man. Clinically, granuloma faciale presents as a reddish-brown or violaceous plaque on the face, often with follicular accentuation and superficial telangiectasias. The sites of predilection are the sides (30%) and tip (7%) of the nose, preauricular area (22%), cheeks (22%), forehead (15%), tip of the nose (7%), and helix of the ear (4%).⁴ Extrafacial granuloma faciale has also been reported but is rare.⁵,6 The clinical differential diagnosis includes sarcoidosis, discoid lupus erythematosus, lymphocytic infiltrate of Jessner, polymorphous light eruption, rosacea, lymphoma cuffs, histiocytosis X, erythema elevatum diutinum, infectious granuloma, and basal cell carcinoma.⁷- 10 Histologically, granuloma faciale displays a dense polymorphous infiltrate of the upper two thirds of the dermis. Eosinophils may be present but are not essential for diagnosis. There is sparing of the epidermis, with a notable Grenz zone and a leukocytoclastic vasculitis in the upper dermis.¹¹
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