A 7-year-old girl with no history of interest referred from her primary care center because of a painful pruriginous lesion in the right cheek that had not improved after oral treatment with amoxicillin/clavulanic acid for two weeks.
On examination, the right cheek showed a cold, erythematous, violet nodule blaming the tattoo, well-defined 1.5 cm in diameter.
No regional adenomegaly was observed, although there was mild keratosis pilaris on the skin of the cheeks.
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Having established the clinical suspicion of IFAG and informed parents about the benignity of the process, they agreed not to perform a skin biopsy and to schedule periodic follow-up, along with metronidazole gel therapy at night.
Two weeks later there was spontaneous drainage of a blood-purulent material from the center of the lesion, with subsequent progressive resolution of the nodule within about 6 weeks.
Cultures for bacteria, mycobacteria from the drainage exudate were negative.
However, after resolution of the nodular lesion, persistent telangiectasias in the affected area have slowly decreased over the 10-month follow-up period.
We advise revisions to the patient until the complete resolution of the process and warn about the need to consult before the appearance of symptoms or clinical signs suggestive of ocular rosacea (dryness, visual acuity or redness).
