Childhood granulomatous periorificial dermatitis: Difference between revisions

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{{Infobox medical condition (new)
{{Infobox medical condition
| name           = Childhood granulomatous periorificial dermatitis  
| name                   = Childhood granulomatous periorificial dermatitis
| synonyms       = '''Gianotti-type perioral dermatitis''' or '''Facial Afro-Caribbean childhood eruption '''
| synonyms               = Facial Afro-Caribbean childhood eruption (FACE)
| image          = 
| field                   = [[Dermatology]]
| caption        = 
| symptoms               = Papular rash around the [[mouth]], [[nose]], and [[eyes]]
| pronounce      = 
| complications           = Possible [[scarring]]
| alt            = 
| onset                   = [[Childhood]]
| field           = [[Dermatology]]  
| duration               = [[Chronic (medicine)|Chronic]]
|
| causes                 = Unknown
| symptoms       =  
| risks                   = More common in [[Afro-Caribbean]] children
| complications   =  
| diagnosis               = [[Clinical diagnosis|Clinical]]
| onset           =  
| differential           = [[Perioral dermatitis]], [[Sarcoidosis]], [[Granulomatous rosacea]]
| duration       =  
| treatment               = [[Topical antibiotics]], [[Topical corticosteroids]]
| types          =
| medication             = [[Metronidazole]], [[Erythromycin]]
| causes         =  
| frequency               = Rare
| risks           =  
| diagnosis       =  
| differential   =
| prevention      =  
| treatment       =  
| medication     =
| prognosis      =  
| frequency       =
| deaths          =  
}}
}}
 
{{Short description|A rare skin condition affecting children}}
'''Childhood granulomatous periorificial dermatitis (CGPD)''', is a rare benign [[granuloma]]tous skin disease of unknown cause.<ref name="Dessinioti2014">{{cite journal|last1=Dessinioti|first1=C|last2=Antoniou|first2=C|last3=Katsambas|first3=A|title=Acneiform eruptions|journal=Clinics in Dermatology|date=January–February 2014|volume=32|issue=1|pages=24–34|doi=10.1016/j.clindermatol.2013.05.023|pmid=24314375|type=Review}}</ref> The disorder was first described in 1970 by Gianotti in a [[case series]] of five children.<ref name="Zalaudek2005">{{cite journal|last1=Zalaudek|first1=I|last2=Di Stefani|first2=A|last3=Ferrara|first3=G|last4=Argenziano|first4=G|title=Childhood granulomatous periorificial dermatitis: a controversial disease|journal=Journal of the German Society of Dermatology|date=April 2005|volume=3|issue=4|pages=252–5|pmid=16370472|type=Review}}</ref> CGPD is more common in boys than girls.<ref name="Kim2011"/>
'''Childhood granulomatous periorificial dermatitis''' (CGPD) is a rare dermatological condition that primarily affects children. It is characterized by the presence of papular eruptions around the orifices of the face, such as the mouth, nose, and eyes. This condition is also known as facial Afro-Caribbean childhood eruption (FACE) due to its higher prevalence in children of African descent.
 
==Clinical Presentation==
==Signs and symptoms==
CGPD typically presents as small, flesh-colored to erythematous papules that are symmetrically distributed around the periorificial areas of the face. These papules may coalesce to form plaques. The condition is usually asymptomatic, although some patients may experience mild itching or burning sensations.
CGPD is characterized by the presence of small, raised, dome-shaped, flesh-colored or yellow-brown [[papule]]s primarily distributed around the mouth, eyes, and nose.<ref name="Dessinioti2014"/> Affected children may also have papules on the ears, eyelids, cheeks, forehead, and nose.<ref name="Dessinioti2014"/> CGPD skin lesions rarely affect areas of the skin other than the face.<ref name="Dessinioti2014"/>
==Etiology==
 
The exact cause of CGPD is unknown. However, it is believed to be a variant of [[perioral dermatitis]], with potential contributing factors including the use of topical corticosteroids, exposure to certain environmental factors, and genetic predisposition. The condition is more commonly observed in children with darker skin types.
==Cause==
The cause of CGPD is unknown.<ref name="Kim2011">{{cite journal |last1=Kim |first1=YJ |last2=Shin |first2=JW |last3=Lee |first3=JS |last4=Park |first4=YL |last5=Whang |first5=KU |last6=Lee |first6=SY |title=Childhood granulomatous periorificial dermatitis |journal=Annals of Dermatology |date=August 2011 |volume=23 |issue=3 |pages=386–8 |doi=10.5021/ad.2011.23.3.386 |pmid=21909215|pmc=3162274|type=Review}}</ref>
 
==Diagnosis==
==Diagnosis==
The approach to diagnosing CGPD is controversial.<ref name="Zalaudek2005"/> Certain [[dermatologist]]s suggest that ruling out infectious and allergic causes of similar skin eruptions and a [[skin biopsy]] demonstrating features consistent with CGPD is adequate for diagnosis. In contrast, other dermatologists advocate for performing a complete history and physical examination and obtaining laboratories and appropriate imaging to rule out cutaneous [[sarcoidosis]].<ref name="Zalaudek2005"/> On microscopy, non-[[tuberculosis|tuberculous]] granulomas with surrounding [[lymphocyte]]s clustered around hair follicles may be seen; additionally, infiltrates of epithelioid [[macrophage]]s, lymphocytes, and [[giant cell]]s may also be seen.<ref name="Zalaudek2005"/><ref name="Kim2011"/> 
The diagnosis of CGPD is primarily clinical, based on the characteristic appearance and distribution of the lesions. A skin biopsy may be performed to confirm the diagnosis, revealing granulomatous inflammation in the dermis. Differential diagnoses include [[sarcoidosis]], [[lupus miliaris disseminatus faciei]], and [[granulomatous rosacea]].
 
==Management==
Several conditions exhibit skin findings similar to those of CGPD. These conditions include [[perioral dermatitis]], [[acne vulgaris]], [[granulomatous rosacea]], [[contact dermatitis]], [[folliculitis]], [[atopic dermatitis]], [[cheilitis]], medication-induced [[acneiform]] eruptions, [[lupus miliaris disseminatus faciei]], [[benign cephalic histiocytosis]], [[granulosis rubra nasi]], [[xanthoma]]s, [[Zinc_deficiency#Skin,_nails_and_hair|zinc deficiency]], [[glucagonoma]], cutaneous [[sarcoidosis]], and [[scabies]].<ref name="Zalaudek2005"/><ref name="Kim2011"/>
Treatment of CGPD involves the discontinuation of any topical corticosteroids and the use of topical or oral antibiotics, such as metronidazole or erythromycin. In some cases, topical calcineurin inhibitors like tacrolimus may be effective. The condition often resolves spontaneously over time, but treatment can help accelerate the resolution of lesions.
 
==Treatment==
Treatment recommendations for CGPD vary and may include observation without treatment, stopping the use of topical corticosteroids, and the use of topical or oral antibiotics as well as [[isotretinoin]].<ref name="Zalaudek2005"/> Topical antibiotics such as [[metronidazole]] and [[erythromycin]] have been used for CGPD.<ref name="Zalaudek2005"/> Oral antibiotics of the [[tetracycline]] class such as [[minocycline]], [[doxycycline]], and tetracycline have been recommended for CGPD.<ref name="Dessinioti2014"/> [[Trimethoprim/sulfamethoxazole]] has also been used.<ref name="Zalaudek2005"/> The use of oral systemic antibiotics is limited by side effects such as [[nausea]], [[vomiting]], and [[photosensitivity|sensitivity of the skin to sunlight]].<ref name="Dessinioti2014"/> Tetracycline antibiotics are not recommended for children under the age of 8 since tetracyclines are known to deposit in teeth (thereby staining them) and impair bone growth in children.<ref name="Dessinioti2014"/> 
 
The use of [[calcineurin inhibitor]] creams such as [[tacrolimus]] or [[pimecrolimus]] on the skin is controversial and results have been mixed.<ref name="Dessinioti2014"/> Certain studies found the use of topical calcineurin inhibitors led to resolution of CGPD whereas others saw incomplete resolution or prolonged symptoms.<ref name="Dessinioti2014"/> Topical [[azelaic acid]] has been used successfully to treat CGPD.<ref name="Dessinioti2014"/> Immediate discontinuation of topical [[corticosteroid]]s is recommended since corticosteroids are thought to worsen CGPD.<ref name="Zalaudek2005"/>
 
==Prognosis==
==Prognosis==
CGPD is known to be a temporary skin disease with a benign course.<ref name="Dessinioti2014"/> The skin papules typically resolve after a few months to a few years. After CGPD resolves, the skin may return to normal without scarring or may have small [[atrophic]] depressions with [[collagen loss]], [[milia]], or small pit-like scars.<ref name="Dessinioti2014"/>
The prognosis for CGPD is generally good, with most cases resolving without significant scarring or complications. However, the condition may persist for several months to years before complete resolution.
 
==Related Pages==
==Epidemiology==
* [[Perioral dermatitis]]
CGPD occurs most often in children of [[Afro-Caribbean]] descent  before [[puberty]] though reports of this disease occurring in [[Asia]]n and [[Caucasian race|Caucasian]] children have also been described.<ref name="Dessinioti2014"/><ref name="Kim2011"/> Due to the limited number of reported cases, it remains controversial whether CGPD occurs more often in African children than in children of other races.<ref name="Zalaudek2005"/> CGPD is more common in boys than girls.<ref name="Kim2011"/>
* [[Granulomatous diseases]]
 
* [[Dermatology]]
==History==
[[Category:Dermatology]]
Gianotti et. al first described CGPD in five Italian children in 1970.<ref name="Kim2011"/> In 1990, Williams et. al described a similar skin eruption in five children of Afro-Caribbean descent and coined the proposed term "facial Afro-Caribbean childhood eruption (FACE)".<ref name="Kim2011"/> Subsequently, another article by Katz and Lesher first introduced the term CGPD since some reported cases were not found in children of Afro-Caribbean descent and to avoid confusion with perioral dermatitis.<ref name="Kim2011"/>
[[Category:Skin conditions in children]]
 
==See also==
[[Perioral dermatitis]]
 
==References==
{{reflist}}
 
[[Category:Cutaneous conditions]]
[[Category:Dermatology stubs]]
[[Category:Dermatitis]]
[[Category:Idiopathic diseases]]
[[Category:Pediatrics]]
[[Category:Rare diseases]]
{{dictionary-stub1}}
{{No image}}

Latest revision as of 22:55, 3 April 2025


Childhood granulomatous periorificial dermatitis
Synonyms Facial Afro-Caribbean childhood eruption (FACE)
Pronounce N/A
Specialty N/A
Symptoms Papular rash around the mouth, nose, and eyes
Complications Possible scarring
Onset Childhood
Duration Chronic
Types N/A
Causes Unknown
Risks More common in Afro-Caribbean children
Diagnosis Clinical
Differential diagnosis Perioral dermatitis, Sarcoidosis, Granulomatous rosacea
Prevention N/A
Treatment Topical antibiotics, Topical corticosteroids
Medication Metronidazole, Erythromycin
Prognosis N/A
Frequency Rare
Deaths N/A


Childhood granulomatous periorificial dermatitis (CGPD) is a rare dermatological condition that primarily affects children. It is characterized by the presence of papular eruptions around the orifices of the face, such as the mouth, nose, and eyes. This condition is also known as facial Afro-Caribbean childhood eruption (FACE) due to its higher prevalence in children of African descent.

Clinical Presentation[edit]

CGPD typically presents as small, flesh-colored to erythematous papules that are symmetrically distributed around the periorificial areas of the face. These papules may coalesce to form plaques. The condition is usually asymptomatic, although some patients may experience mild itching or burning sensations.

Etiology[edit]

The exact cause of CGPD is unknown. However, it is believed to be a variant of perioral dermatitis, with potential contributing factors including the use of topical corticosteroids, exposure to certain environmental factors, and genetic predisposition. The condition is more commonly observed in children with darker skin types.

Diagnosis[edit]

The diagnosis of CGPD is primarily clinical, based on the characteristic appearance and distribution of the lesions. A skin biopsy may be performed to confirm the diagnosis, revealing granulomatous inflammation in the dermis. Differential diagnoses include sarcoidosis, lupus miliaris disseminatus faciei, and granulomatous rosacea.

Management[edit]

Treatment of CGPD involves the discontinuation of any topical corticosteroids and the use of topical or oral antibiotics, such as metronidazole or erythromycin. In some cases, topical calcineurin inhibitors like tacrolimus may be effective. The condition often resolves spontaneously over time, but treatment can help accelerate the resolution of lesions.

Prognosis[edit]

The prognosis for CGPD is generally good, with most cases resolving without significant scarring or complications. However, the condition may persist for several months to years before complete resolution.

Related Pages[edit]

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