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Childhood granulomatous periorificial dermatitis of 2 years duration unresponsive to the topical tacrolimus
( Bo Young Kim ) , ( Chang Min Kim ) , ( Seung Hyun Chun ) , ( Ji Min Lee ) , ( Hwa Jung Ryu ) , ( Il Hwan Kim )
UCI I410-ECN-0102-2017-510-000081789
This article is 4 pages or less.

Childhood granulomatous periorificial dermatitis(CGPD) is a benign facial eruption characterized by monomorphous, small papular eruptions around the central face. CGPD is the benign, self-limited disease and typically persists for several months. We report a 12-year-old boy with multiple erythematous papular eruptions of 2 years duration on the perioral, perinasal and lower eyelid. The eruptions initially showed the improvement after 2 weeks of tacrolimus, and pimecrolimus treatment, but there were residual eruptions and they repeated relapsing-remitting for 1 year despite of the topical treatment. The eruptions even aggravated after two summers. Histopathological examination revealed a perifollicular granulomatous infiltrate. A Final diagnosis of CGPD was established based on the clinical manifestation and histopathology. He was treated with oral tetracycline 1g/day. After 10 weeks of treatment, the lesion was dramatically improved. To the best of our knowledge, this is unusual that CGPD persists longer than 2 years. Based on literature review and this case, tacrolimus monotherapy can be one of treatment choices for early lesion of CGPD or failure of systemic treatment of CGPD. However, systemic therapy like oral tetracycline can be more effective than topical tacrolimus in case of chronic and untreatable CGPD.

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