Granuloma faciale treated successfully with topical tacrolimus

Tomson, N.; Sterling, Jane; Salvary, I.

doi:10.1111/j.1365-2230.2008.02874.x

Cited by 9 publications

(9 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Topical tacrolimus as monotherapy may also be helpful. 7 It has been suggested that the accumulation of the inflammatory infiltrate in granuloma faciale is mediated by interferon-γ. 8 Tacrolimus is thought to be useful, since it inhibits the release of this inflammatory mediator.…”

Section: Discussionmentioning

confidence: 99%

Complete Clearance of Resistant Granuloma Faciale With Pulsed Dye Laser After Pre-treatment With Mometasone and Tacrolimus

Micallef

Boffa

2017

J Lasers Med Sci

View full text Add to dashboard Cite

IntroductionGranuloma faciale is an uncommon, idiopathic, inflammatory dermatosis that usually affects the face.1 Despite its benign nature, the condition tends to be persistent, can be cosmetically distressing and is notoriously difficult to eradicate completely. 2 We report a case of successful treatment of granuloma faciale using 595-nm pulsed dye laser following topical mometasone and tacrolimus. Case PresentationA 39-year-old English lady with Fitzpatrick skin phototype II, presented to our Dermatology Department with 3 sharply-demarcated, reddish-brown, indurated plaques with accentuated follicular openings and few superficial telangiectases. These were present on both cheeks and the tip of the nose. The patient had been previously diagnosed with granuloma faciale in the United Kingdom 6 months previously and was started on dapsone 50 mg daily, to which there was no visible response. The patient then moved to Malta where dapsone was stopped and the lesion on the right cheek biopsied. The biopsy showed a dense neutrophilic and eosinophilic infiltrate within the papillary and reticular dermis, with a prominent Grenz zone, confirming the diagnosis of granuloma faciale. At this point, treatment with pulsed dye laser was attempted. A test area in the right cheek lesion underwent two treatments with a ScleroPlus pulsed dye laser (Candela Corporation, Wayland, Mass) with cryogenspray dynamic cooling. A wavelength of 595 nm and pulse duration of 1.5 ms were used, with a 7 mm spot at a fluence of 8.5 J/cm 2 for the first session and 9.5 J/ cm 2 for the second session, carried out after an interval of 8 weeks. There was no visible improvement with this treatment. The patient was lost to follow-up but re-presented 5 years later with the same lesions, which by then had become more prominent. She was prescribed mometasone 0.1% ointment once daily for 2 months, with no visible improvement. Tacrolimus 0.1% ointment twice daily was then added to the mometasone ointment for another 2 Case Report Abstract Introduction: Granuloma faciale is an uncommon inflammatory dermatosis which usually affects the face and is often resistant to treatment. Case Report: A 39-year-old English lady with Fitzpatrick skin phototype II presented with typical lesions of granuloma faciale, confirmed on biopsy, on her cheeks and nose. Treatment with ScleroPlus pulsed dye laser (Candela Corporation, Wayland, Mass) produced no visible improvement. The patient re-presented 5 years later with the same lesions, now more prominent. No improvement was noted with topical mometasone, however addition of topical tacrolimus caused significant flattening. Since the erythema and telangiectases persisted, treatment with ScleroPlus pulsed dye laser was re-attempted. Treatments were performed with a wavelength of 595 nm, pulse duration of 1.5 ms and 7 mm spot at a fluence of 8.5 J/cm2 in the first session and 9.5 J/cm 2 in the subsequent 2 sessions. This resulted in complete resolution without scarring or pigmentary change. There was no recurrence at follow-up ...

show abstract

Section: Discussionmentioning

confidence: 99%

Complete Clearance of Resistant Granuloma Faciale With Pulsed Dye Laser After Pre-treatment With Mometasone and Tacrolimus

Micallef

Boffa

2017

J Lasers Med Sci

View full text Add to dashboard Cite

show abstract

“…Therefore, topical, intralesional and systemic corticosteroids, electrosurgery, cryotherapy, diverse modalities of laser, dapsone, clofazimine, colchicine, PUVA therapy, dermabrasion or surgical excision have previously been applied with different responses [2][3][4] . In addition, topical calcineurin inhibitors have been shown to be effective in several inflammatory diseases [3,7] such as pemphigus foliaceus, discoid lupus erythematosus, granulomatous periorificial dermatitis [8] , erosive pustular dermatosis of the scalp [9] and even in other rare conditions such as cutaneous plasmocytosis [10] .…”

Section: Color Version Available Onlinementioning

confidence: 99%

“…Tacrolimus acts by binding and inactivating calcineurin, so T-cell activation and proliferation are blocked. As a result, secretion of ␥ -interferon is inhibited [2] . In addition, a decrease in interleukin 5 production by topical tacrolimus may lead to a reduction of the number of eosinophils present in the lesions [4] .…”

Section: Color Version Available Onlinementioning

confidence: 99%

“…In addition, eosinophils and plasma cells are prominent in GF, whereas neutrophils are plentiful in erythema elevatum diutinum [1] . GF is often quite resistant to therapy [2][3][4][5][6] . Topical calcineurin inhibitors may represent a useful alternative to topical corticosteroids for the treatment of a number of other inflammatory skin diseases different from atopic dermatitis [7] .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Successful Response to Topical Tacrolimus for a Granuloma Faciale in an Elderly Patient

Pérez-Robayna¹,

Rodríguez‐García²,

González-Hernández³

et al. 2009

Dermatology

View full text Add to dashboard Cite

“…Topical tacrolimus has recently been shown to be a safe and effective treatment option for GF 2–6 . This immunosuppressive agent inhibits T‐cell proliferation and production and the release of several pro‐inflammatory cytokines, including interleukin‐2 (IL‐2), IL‐4, tumor necrosis factor‐α, and interferon‐γ (IFN‐γ) 7 .…”

mentioning

confidence: 99%