Under the title of isolated chancre-like pyoderma of the skin of the face (pyoderma chancriforme faciei), Hoffmann1 reported 5 cases of almost identical lesions which appeared as single foci on the face. The lesion in each case resembled a button-like, eroded or ulcerative chancre or vaccinia. The base was indurated and superficial (rarely deep), with smooth ulceration and without a separating border. The secretion was serous rather than purulent. The thin, elevated border was bright red, and the crusts were yellowish or darker. There was a hard, almost indolent swelling of the regional lymph gland. In 1 case a lesion identical in character with the original appeared symmetrically eleven months later on the opposite eyelid.
The ulcers occurred most commonly on soft skin, where irritation or maceration by tears or sputum might favor development. There were no important subjective symptoms. The lesions responded to antiseptic applications.
The laboratory findings,
STRYKER GV. PYODERMA CHANCRIFORME FACIEI. Arch Derm Syphilol. 1940;42(3):447–449. doi:10.1001/archderm.1940.01490150051008