Unsuspected Malignant Mimicry From Topical Vitamin E and Micro Spike Roller

Head Neck. 2025 Feb;47(2):E28-E31. doi: 10.1002/hed.27996. Epub 2024 Nov 22.

Abstract

Background: 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.

Methods: 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.

Results: The lesion was significantly improved with Kenalog injection treatment over 18 months. A scar excision procedure further enhanced the lesion cosmetically.

Conclusions: This case highlights the rarity and clinical diversity of vitamin E skin reactions, and their potential to mimic malignancies.

Keywords: contact allergy; derma roller; malignancy; vitamin E; xanthogranulomatous inflammation.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Antioxidants / administration & dosage
  • Antioxidants / therapeutic use
  • Diagnosis, Differential
  • Female
  • Humans
  • Middle Aged
  • Skin Neoplasms* / pathology
  • Vitamin E* / administration & dosage
  • Vitamin E* / therapeutic use

Substances

  • Vitamin E
  • Antioxidants