Beyond the Lesion: A Retrospective Study of Idiopathic Facial Aseptic Granuloma in Children Focusing on Ultrasound Findings and Their Association with Chalazia

Introduction: Idiopathic facial aseptic granuloma (IFAG) is an uncommon granulomatous lesion associated with childhood rosacea. Affected children often experience recurrent eyelid chalazia. Objectives: We present a single-center retrospective study of 16 cases of IFAG in order to assess their clinical course and discuss any therapeutic intervention. Methods: Children presenting with facial lesions persisting for at least six weeks which exhibited clinical features of an (IFAG) were included in the study. Results: There were 10 females and six males, with a mean age of 6.4 (± 4) years. The mean time from the onset of treatment to complete resolution of lesions was 11 months for the children treated with a topical regimen and 7.2 months for those children treated with both topical and systemic antibiotics respectively (P<0.005). Ultrasound examination revealed a solid, hypoechoic lesion with increased perilesional or intralesional blood flow in the hypodermis without any calcium deposit as an early finding. Skin biopsies were performed in seven children. Recurrent chalazia were reported in all 16 cases. Conclusions: IFAG is a benign lesion that may persist for several months before resolution. Ultrasound examination is a valuable tool for establishing a diagnosis. Clinicians should monitor children with IFAG for potential ocular complications that may arise later in life.