case_images: PMC11833711_01
case_images: A, Baseline. B, Improvement following a 3-month course of twice daily application of topical sirolimus 0.2% gel (Hyftor), using 20 gm per month. C, Sustained improvement after 9 months of treatment, using 10 gm per month. D, Residual hyperpigmentation consistent with erythromelanosis follicularis faciei et colli, noted 1 week off treatment, with summer sun exposure.
case_images: gr1.jpg
case_images: PMC11833711_01_gr1.jpg
case_images: fig1
case_images: His skin exam featured symmetric patterned moderate erythema on both cheeks with associated densely scattered pinpoint keratotic papules characteristic of KPRF (Fig 1, A). After using 20 gm/month for 3 months, he was very pleased with improvement in both appearance and flushing and denied adverse effects (Fig 1, B). The condition remained in remission for 6 more months, using only 10 gm/month (Fig 1, C). This visit was in July, and only residual hyperpigmentation was noted, likely related to sun exposure and consistent with erythromelanosis follicularis faciei et colli (Fig 1, D).