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Rosacea fulminans (pyoderma faciale): successful treatment of a 3‐year‐old girl with oral isotretinoin

A 3‐year‐old girl presented with several erythematous papules, pustules, cysts, and purulent discharging sinuses on the face. The lesions suddenly appeared on the cheeks 3 months previously and then rapidly extended to other areas of the face. She had been treated with a variety of topical and systemic antimicrobials (including erythromycin, cephalexin, dicloxacillin, and suIfamethoxazole‐trimethoprim) and topical corticosteroids with no effect. Examination revealed deep red erythema of facial skin with several papules, pustules, cysts, and draining sinuses on the cheeks, chin, perioral, and paranasal areas ( Fig. 1 ). No comedones or signs of hidradenitis suppurativa were observed. The child was otherwise in good health. She did not have a family history of severe acne vulgaris.