Unsuspected Malignant Mimicry From Topical Vitamin E and Micro Spike Roller

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.