Surgical treatment of solid facial edema: when everything else fails

A case of persistent solid facial edema is presented to illustrate and discuss this rare, poorly understood condition. It is most frequently a sequela of acne vulgaris, but it can also be caused by other congenital, infectious, and inflammatory processes. This entity is notoriously difficult to treat. Many therapeutic modalities have been tried. Early treatments with isotretinoin, clofazimine, and ketotifen have been occasionally effective while no treatment has been proven successful in the later stages. This is probably the first time that surgical treatment of this problem has been reported. This experience and a review of the literature may prove helpful to other practitioners in our specialty.