Pyoderma Faciale (Rosacea Fulminans)

Figure 3.5 A: Lupus miliaris disseminatus faciei (Courtesy of Dr. Iris K. Aronson) B: Pyoderma faciale (Courtesy of Dr. Paul Getz) C: Plaque psoriasis

• Mainly seen in postadolescent females; may be rare variant of rosacea
• Presents with acute onset of erythematous papules, pustules, nodules and abscesses in centrofacial region with background of dull cyanotic erythema, ± draining sinuses; ± mild systemic symptoms (myalgias, fever, ↑ ESR, ↑ WBC)
• Treatment: initial use of oral corticosteroid followed by low-dose isotretinoin and slow taper of corticosteroid