Pyoderma faciale
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Synopsis

Pyoderma faciale, also known as rosacea fulminans, is an acute, inflammatory eruption almost exclusively seen on the face of young women and characteristically sparing the trunk. This is an uncommon disorder manifested by the sudden onset of large, tender, inflammatory papules, pustules, and nodules on the face. Pyoderma faciale lacks systemic symptoms.
The etiology is unknown; however, the majority of patients report a history of rosacea or facial flushing. Triggers may include hormonal changes (ie, pregnancy, oral contraceptives, menopause) or emotional stressors. Pyoderma faciale has been noted in case reports to occur in association with inflammatory bowel disease (IBD) and small intestinal bacterial overgrowth (SIBO).
The etiology is unknown; however, the majority of patients report a history of rosacea or facial flushing. Triggers may include hormonal changes (ie, pregnancy, oral contraceptives, menopause) or emotional stressors. Pyoderma faciale has been noted in case reports to occur in association with inflammatory bowel disease (IBD) and small intestinal bacterial overgrowth (SIBO).
Codes
ICD10CM:
L08.0 – Pyoderma
SNOMEDCT:
29909004 – Pyoderma faciale
L08.0 – Pyoderma
SNOMEDCT:
29909004 – Pyoderma faciale
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Furunculosis
- Severe cystic acne
- Acne fulminans – Presents with systemic symptoms (ie, fever, malaise, arthralgias) and involves comedonal lesions and extrafacial lesions.
- Acne conglobata
- PAPA syndrome
- PASH syndrome
- PAPASH syndrome
- Rosacea
- Steroid-induced rosacea
- Halogenoderma (bromoderma, iododerma)
- Botryomycosis
- Actinomycosis
- Histoplasmosis
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:10/15/2020
Last Updated:11/18/2020
Last Updated:11/18/2020