Idiopathic facial aseptic granuloma is a childhood dermatosis characterized by a single soft, painless, red papule or nodule on the face. ICD-10 Code: L71.9
The disease occurs in children between the ages of 8 months and 13 years. The etiology and pathogenesis are not well understood. Bacteriologic studies of the lesion site for bacteria, fungi, and mycobacteria are negative, although there are isolated reports of secondary infection with Staphylococcus aureus, certain species of Streptococcus, and Enterococcus faecalis.
Because of its frequent association (up to 40%) with chalazion, facial erythema, telangiectasia, papules, and pustules, most authors consider this disease to be a childhood form of granulomatous rosacea.
The disease is characterized by the appearance of a single, painless, soft, red or purple papule that rapidly enlarges to a size of 10 to 30 mm. Rarely, 2-3 rash elements may be observed.
Typical sites are the cheeks, less commonly the periorbital area and the eyelids. The course is chronic and spontaneous resolution of the process occurs within 2-12 months.
- Folliculitis / Abscess
- Atypical Spitz nevus
- Resolving infantile hemangioma
- Pilomatricoma
- Pyogenic granuloma
- Botryomycosis
- Cat-scratch disease
- Sporotrichosis
- Cutaneous leishmaniasis
- Molluscum contagiosum
- Mastocytoma
- Juvenile xanthogranuloma
- Langerhans cell histiocytosis
- Subepidermal calcified nodules
Spontaneous involution within a few months - does not require treatment. Macrolides (azithromycin, erythromycin, and clarithromycin orally for 2 weeks to 2 months), tetracyclines (in children older than 9 years), and topical cream with metronidazole have been used with variable success. In persistent cases, incision and drainage or surgical excision of the lesion may be performed.