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Patient Case
A woman in her 50s with no relevant medical history other than multiple cardiovascular risk factors presented with lesions on her nose persisting for a year and gradually increasing in size, initial treatment with doxycycline for two months showed no improvement. Following a biopsy, which revealed granulomas with a significant lymphocytic infiltrate, suggestive of granulomatous rosacea, PCR testing for M. tuberculosis returned negative. Subsequently, the patient was initiated on isotretinoin 20 mg/day. However, despite this treatment, only mild improvement was observed, as depicted in the first photo after two months of isotretinoin. Upon presentation, the patient’s condition is as shown in the second photo.
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