Pyoderma faciale is an unusual skin condition occurring in young adult women. It is also called ‘rosacea fulminans’. Some specialists consider Pyoderma Faciale to be a form of severe acne, while others define pyoderma faciale as a manifestation of rosacea. What everyone can agree on is the physical appearance of Pyoderma faciale. Pyoderma faciale is defined as inflamed cysts localized on the face of females. It typically affects women in their early 20s and severe scarring may result in untreated cases. Large erythematous papules, pustules and nodules characterize pyoderma faciale. Comedones are absent. There are unsightly and painful large red tissue nodules, pustules and sores on very red areas of the cheeks, chin and/or forehead. The lesions may leave scars. Despite the severity of the inflammation, there are no internal symptoms. No infective organisms are found in bacterial cultures of the affected skin.

Considered by some to be an acne imposter, Pyoderma faciale is also referred to as rosacea fulminans. Pyoderma faciale affects young to middle-aged women with either no prior skin complaints or with mild rosacea. Edema, nodules, and draining sinuses may occur. Pyoderma faciale is an uncommon acute presentation of rosacea. Like rosacea, pyoderma faciale may display a rapid onset of nodules, papules and pustules. Pyoderma faciale rarely persists more than a year or so before going into a remission. It is not associated with oily skin, does occur as a result of acne comedones. Pyoderma faciale is confined to the face areas. This is something that affects women but not men, leading one to speculate on a hormonal connection.

Pyoderma faciale can resemble severe acne in that it affects younger women; it is not associated with flushing and does not affect eyes as in the case of ocular rosacea . Pyoderma faciale is considered to be a severe form of acne, which is usually found in adult women. Clogged skin pores and bacterial infections define acne. The blackheads, whiteheads and pimples associated with acne are not associated with rosacea.

The pimples, pustules, and cysts that occur in rosacea may look like typical acne, but closer scrutiny reveals the absence of whiteheads and blackheads. In rosacea, the pimples and cysts rarely appear on the chest and back. Rosacea consists of red bumps called papules. These papules are usually solid and hard. The papules range in size from small bumps that resemble the measles or chicken pox, all the way to larger, penny-shaped nodules.

Pyoderma faciale usually attacks the face, cheeks, chin and forehead. It does not affect males and is confined to the face alone. These are large red nodules or pustules that may be painful and leave permanent scars. Whether it is called rosacea or acne this is a very rare condition.

Management of Pyoderma faciale is quite a difficult task. It requires strict attention to detail and commitment. Dermatologists are often baffled on how to treat pyoderma faciale. There is no general standard of treatment, so far none have been very effective and most resort to accutane and antibiotics.

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