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Questions for Dr. Kennedy
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Unusual Facial Sore
Posted by: Shinah
Date: May 5, 2002 1:20 PM

Eight months ago, my 5 year old daughter had an unusual mark appear on the right cheek above the chin line. It was pea-sized, and had a bluish black color. It stayed the same for about 2 months, then suddenly it became reddened and slightly raised. There was no head or pustule formation, yet it was hot and became larger. A doctor said it appeared to be an infected hair follicle or sebaceous gland and prescribed black currant oil supplement and an herbal antibiotic. It seemed to improve but then worsened with much pain to touch deepened inflammation. A dermatologist lanced it and a clear liquid and blood drained from it, no pus. The doctor pescribed Duricef to discourage infection and sent us to an ear/nose/throat/oncologist/plastic surgery group for a second opinion. Bug bites and cancer were ruled out. Several rounds of antibiotics were prescribed as it worsened and the scar from the lance opened and began to discharge blood and pus. Augmentin was presribed. She is now on a probiotic formula and Vit. A tablets.



Edited 2 time(s). Last edit at May 13, 2009 8:32 PM by Dr. Kennedy.

RE: Unusual Facial Sore
Posted by: Ron Kennedy, M.D.
Date: May 5, 2002 9:27 PM

The most important principle of medicine is to get a diagnosis before treatment, if at all possible. It sounds like you have taken a few shots in the dark. From a diagnostic as well as a treatment standpoint, surgical excision is not such a bad idea. As to what this might be, very hard to say without seeing it, and then it might be difficult for any doctor unless he/she had already seen something like it before. What comes to my mind from your description, although I am not trying to diagnose the problem, is an arteriovenous malformation which was somehow traumatized and now refuses to heal. A-V malformations are congenital (present at birth) and are direct vascular connections between the arterial system and the venous system, bypassing the capillaries. Unless they are quite large, they are not a health problem and can go undetected for a lifetime. Doppler studies will usually give the diagnosis and the type of docs that do that procedure most commonly are vascular surgeons. If that is the diagnosis, a vascular surgeon would be the best choice to perform the surgical correction.



Edited 1 time(s). Last edit at October 29, 2007 4:50 AM by Dr. Kennedy.



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