A Young Child with a Devastating Facial Lesion

March 21, 2016
Sarah Siu

,
Richard Sidlow, MD

,
Eve J Lowenstein, MD

What disease, known in antiquity but largely eradicated from the developed world, caused this severe facial scarring?

An undernourished child presents with a facial lesion present for some months (Figure). The problem started as a gingival ulcer with facial edema and progressed to a necrotic black escar. After sloughing of the escar and the external cheek skin, the area finally healed with a scar and retraction over the course of the next weeks.

What is the most likely diagnosis?

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