Childhood granulomatous periorificial dermatitis: a controversial disease

The etiology, diagnosis and treatment of childhood granulomatous periorificial dermatitis (GPD) are highly controversial. Some authors underline the similarities between GPD and perioral dermatitis and consider both as part of a spectrum while other authors regard GPD as a distinctive condition. Clinically GPD is a papulo-pustular periorificial disease of the face which histopathologically shows a granulomatous perifollicular infiltrate. Because of its granulomatous pattern, GPD also has been related to cutaneous sarcoidosis. The clinical course is benign and self-limited. Topical steroids are regarded as either the main cause or a worsening factor. While topical treatment is occasionally effective, systemic antibiotic therapy of GPD is usually recommended. We report a "typical" case of GPD and review the literature to discuss the difficulties in its diagnosis and treatment.