A 14-yo girl with no PMHx c/o papules on her nose and cheeks for years. She has tried OTC and prescription acne products without improvement. Current meds: benzoyl peroxide 10% wash, tretinoin 0.025% cream, and topical clindamycin 1%. What is it?
Angiofibromas
Gram-negative folliculitis
Contact dermatitis
Resistant acne vulgaris
Rosacea
You are correct. Angiofibromas are small, skin-colored to yellow-red, translucent papules located symmetrically over the forehead, nose, and cheeks. They are associated with tuberous sclerosis, an autosomal dominant condition. The classic triad of epilepsy, learning difficulties, and angiofibromas occurs only in a small minority of cases, however. Lesions may be misdiagnosed as acne vulgaris, but do not respond to acne therapy. They can be treated for cosmesis with shave excision, dermabrasion, or laser tx; recurrence is common.