Biopsy may help identify early pyoderma faciale (rosacea fulminans)

Pyoderma faciale is an uncommon acute presentation of rosacea. Edema, nodules, and draining sinuses may occur. Women in their early 20s are typically affected, and severe scarring may result in untreated cases. We report the case of a woman in whom a biopsy helped establish an early diagnosis so that decisive intervention could be initiated and scarring avoided. The histologic features of pyoderma faciale only rarely have been described and are illustrated in this case.