Unsuspected Malignant Mimicry From Topical Vitamin E and Micro Spike Roller.

Abstract

Topical vitamin E is commonly used for its antioxidant properties in a rapidly expanding anti-aging market. Cutaneous reaction to vitamin E is rare and can present a difficult diagnosis. We report a unique case of a 46-year-old female who developed a severe cutaneous inflammatory chin lesion after topical use of vitamin E oil with a micro-spike roller. Clinical examination found a friable and fungating mass which prompted biopsy due to suspected malignancy. Pathology ruled out malignancy and revealed chronic inflammation with xanthogranulomatous-like features. The lesion was significantly improved with Kenalog injection treatment over 18 months. A scar excision procedure further enhanced the lesion cosmetically. This case highlights the rarity and clinical diversity of vitamin E skin reactions, and their potential to mimic malignancies.