Persistent facial pustular plaque on the face

Abstract

A 66-year-old female patient presented to our clinic for excision of a cutaneous, squamous cell carcinoma. In addition, she presented with a left preauricular, erythematous, sharply demarcated plaque of 10 × 5 cm diameter with multiple pustules, with involvement of the earlobe, that had been slowly progressing in size for five years (Figure 1). An externally performed biopsy was consistent with granulomatous rosacea, explaining the unsuccessful outcome of the patient's threemonth systemic treatment with isotretinoin and topical treatment with ivermectin.