Description
A middle-aged woman presented with a 'pimple that won't heal'. She stated that it slowly enlarged over her left cheek for 6 months. She denied any symptoms of itchiness nor pain. She previously tried topical metronidazole for 6 weeks without improvement. She used acetaminophen and ibuprofen on occasion for 10 years to combat her migraine headaches, plus her neurologist recently initiated her on gabapentin. The patient noted that her presenting problem started 3 weeks after she initiated the gabapentin. Throughout this period of time, she also continued to take ibuprofen approximately three times weekly. She denied using any other medicines. Additionally, she denied a bug bite to her left cheek. On examination, a single dime-sized, non-scaly plaque with slight erythema was located on her left cheek (figure 1). The rest of her skin exam was unremarkable. A single punch biopsy revealed a dermal mixed infiltrate consisting of predominantly...
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