[Clinical and histological study of a case of facial Afro-Caribbean childhood eruption (FACE)].

BACKGROUND

The term Facial Afro-Caribbean childhood eruption (FACE) was coined in 1990 to describe a perioral granulomatous eruption in black-skinned children. We present a typical case of this condition, together with a histological and immunohistochemical study.

PATIENTS AND

METHODS

A seven-year-old boy with black skin was referred for numerous nonpruritic papules that appeared on his face several months prior to the consultation. He had a past history of atopic dermatitis, but his mother denied any use of steroids or other topical treatment on his face. Examination showed numerous small lupoid and flesh-colored papules localised in the perioral, perinasal and periocular areas. Biopsy revealed a diffuse granulomatous infiltrate of the dermis comprising histiocytes, multinucleated giant cells and a heavy lymphocytic component. Histiocytes were CD68+ and CD1a-, while the majority of lymphocytes were CD3+ (70% CD8+ and 30% CD4+).

DISCUSSION: This particular type of perioral dermatitis is seen chiefly in male children with black skin. Our histologic study revealed a diffuse and massive granulomatous infiltrate of the dermis, in contrast with the small size of the papules. Expression of CD68, absence of necrosis and dense CD3+ infiltrate in this disease resembles findings in the granulomatous variant of rosacea. This entity must be differentiated from lupus miliaris disseminatus faciei and from sarcoidosis.