Unilateral Multiple Facial Angiofibromas: A Case Report with Brief Review of Literature
A-30-year-old unmarried male born of non-consanguinous marriage presented for evaluation of right-sided facial papules that were first noted at 15 years ago. The lesions reportedly began as flat-topped, skin-colored, and erythematous papules involving the right side of his face. He denied history of any previous treatment. During last five years, gradually increasing numbers of new and similar lesions have appeared and spread to involve the right cheek, right nasofacial sulcus, and the right side of the nose.\nOn examination, the patient has multiple, discrete, 2-5 mm, flat, skin-colored and hyper-pigmented papules involving the right cheek and right side of the nose []. There were no periungual fibromas, shagreen patches, café-au-lait macules, forehead plaques or hypopigmented patches. Rest of cutaneous and systemic examination was unremarkable. The patient has no evidence of mental retardation and no history of seizures, cardiopulmonary lesions, renal lesions, or retinal abnormalities. There was no family history of similar cutaneous lesions or seizures.\nOur clinical differential diagnosis included angiofibromas, verruca plana, syringoma and trichoepitheliomas.\nAs there were no other cutaneous signs of TSC, the patient denied further evaluation and imaging studies to rule out internal manifestations of TSC.\nSkin biopsy specimens of the facial papules revealed characteristic findings of angiofibromas, namely telangiectases, perivascular and periadnexal concentric dermal fibrosis, and large stellate fibroblastic cells scattered in the upper dermis. [Figures and ] Based on above observations a final diagnosis of unilateral facial angiofibromas was made. Patient was advised cryotherapy for his lesions, but we lost the follow-up with patient.