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Standard treatment of steroid-induced rosacea includes discontinuation of steroids and use of an oral tetracycline. A temporary decrease to a lower-potency steroid prior to discontinuation remains optional. The limitations of standard therapy include a prolonged course of treatment with exacerbations prior to permanent improvement. Our challenge was to identify a treatment regimen to resolve steroid-induced periocular rosacea quickly and with minimal rebound effect.

Traumatic arteriovenous fistulas can present days to years following penetrating trauma and are often challenging to diagnose and manage. Patients may present to the dermatologist with unilateral varicose veins or a pulsatile mass. Our case illustrates the value of palpation in a careful systematic approach to any new lesion, especially in the context of previous penetrating trauma. We also discuss the nomenclature of arteriovenous communications and review their current management.

Acrospiromas are cutaneous tumors of sweat duct differentiation. They usually present as slowly enlarging 1 to 2 cm nodules in middle-aged or older adults without site predilection. On histologic examination they are multilobular dermal masses composed of a biphasic cell population. Acrospiromas are benign, and treatment consists of surgical excision.