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case_images: Clinical photographs show the progression of the patient's condition. (A) Before and; (B) 2; (C) 4; (D) 6; (E) 8; and (F) 12 weeks into abrocitinib 100 mg daily treatment; (G) 16 weeks into abrocitinib 100 mg every other day and; (H) 20 weeks into abrocitinib 100 mg twice weekly treatment. The location of the biopsy (red arrow).
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case_images: Physical examination revealed bilateral, symmetrical erythema on the cheeks with well-defined borders, mild swelling and infiltration, and slight capillary dilatation (Figure 1A). After 20 weeks of treatment and subsequent follow-ups, she experienced significant improvements in erythema, swelling, and capillary dilatation (Figures 1B-H and 4).
case_images: Histopathological examination of granulomatous rosacea. (A and B) The epidermis appears largely normal, and a large number of granulomas composed of epithelial cells, lymphocytes, and multinucleated giant cells can be observed around the hair follicles in the dermis, with no signs of caseous necrosis.
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case_images: Small neutrophilic abscesses and epithelioid granuloma formation were also observed (Figure 2).
case_images: Acid-fast staining and PAS staining in granulomatous rosacea. (A) Acid-fast staining did not detect any acid-fast bacilli; (B) PAS staining showed negative results.
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case_images: Specialized staining tests, including acid-fast and Periodic acid-Schiff staining, showed negative results (Figure 3).
case_images: Images during clinical treatment with abrocitinib (VISIA). (A-C) Abrocitinib 100 mg daily treatment week 12; (D-F) Abrocitinib 100 mg every other day treatment week 16; (G-I) Abrocitinib 100 mg twice weekly treatment week 20.
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case_images: After 20 weeks of treatment and subsequent follow-ups, she experienced significant improvements in erythema, swelling, and capillary dilatation (Figures 1B-H and 4).