[Solitary congenital plaque-like telangiectatic glomangioma].

Glomus tumors comprise a group of relatively rare neoplasms. They may be either solitary or multiple. The latter constitute less than 10% of all cases, and in the traditional classification they were divided into disseminated and localized forms.1,2 In 1990, another form, called congenital multiple plaquelike glomus tumors, was described by Landthaler et al.3 Subsequently, in 1998, Requena et al4 described a rare variety cellular migration) in epidermal keratinocytes following treatment with C225. This is related to a change in the in vivo regulation of follicular and epidermal homeostasis mediated by EGFR, leading to the appearance of the acneiform eruption.5,12,13 Cultures fail to show an infectious agent as the cause of the eruption, a factor which supports the diagnosis.35,8,9 The histopathologic study of the lesions shows a follicular reaction consisting of an intense neutrophilic inflammatory infiltrate surrounding the infundibuli,5,12 which sometimes appear hyperkeratotic.6 A differential diagnosis should be established with rapid-onset follicular eruptions, whether they are established entities or drug reactions; among the most common drug reactions are those produced by vitamin B12, corticosteroids, androgens, lithium, tuberculostatic drugs, halogens, some tricyclic antidepressants, anticonvulsive drugs, and immunosuppressors. The eruption usually responds to tetracyclines such as minocycline at 100 mg/d, or doxycycline at the same dose. Currently no consensus exists as to the duration of treatment.3,9,10,14 Recurrence is relatively frequent, although less intense than the initial episode. In view of the increased use of biological therapy in a variety of specialties, we can expect to see this entity with increased frequency in everyday dermatological practice. Dermatologists should therefore consider it as soon as the patient’s history is taken, thus avoiding invasive tests such as biopsy in many cases. Tetracyclines are currently the treatment of choice and there have been few reports of therapeutic success with alternatives such as metronidazole, used in the present case, or other systemic antibiotics.