A 79-year-old man presented with a left nasolabial fold skin lesion that intermittently bled then crusted without other drainage. Physical examination revealed a 2- to 3-mm erythematous papule with crusting and surrounding induration (Figure 1). Dental evaluation, including panoramic films, showed diffuse periodontal disease without periapical abscess or palpable intraoral cords. The patient had been treated previously with antibiotics for this condition. He had multiple recurrences of nondraining nodular lesions in the nasolabial fold area, despite repeated excision by different physicians. The excisional specimens were interpreted as epidermal inclusion cyst on multiple occasions (Figure 2). Cultures and stains of biopsy material were negative for acid-fast bacilli and fungi but did yield coagulase-negative Staphyloccocus and Corynebacterium species on one occasion.
Palacio JE, Altemus DA, Christensen ED, Sorensen GW. Unusual Recurrent Facial Lesion. Arch Dermatol. 1999;135(5):593-c-598. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-5-dof8025