Topical calcineurin inhibitors for pediatric periorificial dermatitis

BACKGROUND

Data regarding the treatment of periorificial dermatitis with topical calcineurin inhibitors (TCI) in the pediatric population are limited.

OBJECTIVE

To assess the clinical utility of TCI in pediatric patients with periorificial dermatitis.

METHODS

A retrospective medical record review of all pediatric patients with periorificial dermatitis treated with TCIs was performed. Follow-up via telephone was performed to capture missing data.

RESULTS

A total of 132 patients met the inclusion criteria. The median age at diagnosis was 4.2 years (interquartile range, 2.3-8.2). The median follow-up was 5.2 months (interquartile range, 2.1-11.7). Seventy-two patients had evaluable follow-up data. Of these, 48 (67%) patients were treated with TCI alone, 12 (16.7%) were treated with a combination of TCI and topical metronidazole, and 9 (12.5%) were treated with a combination of TCI and a systemic antibiotic. Complete response was noted in 68.8% of patients treated with TCI alone, in 75% of patients treated with TCI and metronidazole, and in 77.8% of patients treated with TCI and a systemic antibiotic. Adverse events were rare and mild in severity.

CONCLUSION

Topical calcineurin inhibitors are an effective therapeutic option for pediatric patients with periorificial dermatitis and were well tolerated in this cohort.

Lupus miliaris disseminatus faciei: a distinctive facial granulomatous eruption

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Palisaded Granuloma on the Nose: An Atypical Presentation of Granuloma Annulare

Granuloma annulare (GA) is a common, asymptomatic dermatosis of unknown etiology. Many variants exist, among them widespread papules, papules in photodistribution, papules marked by tiny crusts ("perforating" GA), patches, plaques, and nodules (subcutaneous GA). The histopathological hallmark is a palisaded histiocytic infiltrate surrounding a central area of degenerated collagen with abundant mucin deposits. We report 2 women who presented with persistent nodules on the nose, which, on histopathological examination, showed a palisaded granuloma. We propose that these cases represent an unusual variant of GA occurring on the nose.