ABSTRACT
Granuloma faciale (GF) is a chronic inflammatory disease of unknown origin characterized by nodular or granulomatous lesions on the face in adults. It is now regarded as a variant of vasculitis in which eosinophils are particularly numerous. It remains a benign, though chronic condition, not associated with systemic lesions like other forms of vasculitis. We report a case of 24-year-old male who presented with multiple erythematous nodules on photoexposed areas since past 2 years. The patient had been previously treated for Hansen’s disease for 3 months but with no relief. The patient responded wonderfully to intralesional triamcinolone and topical tacrolimus after two initial failed attempts with intralesional cryotherapy.
ABSTRACT
Granuloma faciale is an uncommon disease of an unknown origin, and it is characterized by single or multiple erythematous facial skin lesions. Histologically, a narrow Grenz zone of normal dermis is observed between the epidermis and the dense dermal polymorphous infiltrates. The course of granuloma faciale is chronic and the response to therapy is usually poor. We report here a case of granuloma faciale in a 37-year-old male who presented with a 13-year history of a solitary, red-brown, soft, elevated, irregular shaped plaque on the chin. The biopsy specimen showed a Grenz zone and a dense, dermal infiltrate of mononuclear cells mixed with numerous eosinophils and neutrophils that displayed a diffuse and perivascular pattern. After 4 courses of intralesional steroid injection, the lesion almost became flattened, although it remained a pinkish patch. The lesion almost cleared up after 4 months of applying 0.03% topical tacrolimus.
Subject(s)
Adult , Humans , Male , Biopsy , Chin , Dermis , Eosinophils , Epidermis , Granuloma , Injections, Intralesional , Neutrophils , Skin , TacrolimusABSTRACT
Granuloma faciale is an uncommon localized form of small-vessel vasculitis characterized by single or multiple lesions on the face in middle-aged whites, especially males. Histopathological examination demonstrates a dense polymorphous cellular infiltrate consisting of neutrophils, eosinophils, lymphocytes and histiocytes in the upper two thirds of the dermis. A characteristic subepidermal Grenz zone separates the infiltrate from the epidermis. We report a case of granuloma faciale, showing interesting evidence of palisaded granuloma-like pattern in the serial biopsy specimen at 3-year interval.
Subject(s)
Humans , Male , Biopsy , Dermis , Eosinophils , Epidermis , Granuloma , Histiocytes , Lymphocytes , Neutrophils , VasculitisABSTRACT
Granuloma faciale is a rare disease of unknown origin characterized by single or multiple cutaneous nodules usually occurring on the face. A narrow grenz zone of normal dermis is usually observed between the epidermis and the dense dermal polymorphous infiltrates. We report a case of granuloma faciale in a 40-year-old male patient with erythematous plaque on his nose. The skin biopsy specimen showed a dense dermal accumulation of inflammatory cells, including neutrophils, eosinophils, monocytes, and lymphocytes. The infiltrate was distributed diffusely throughout the involved dermis and it focally involved the thinned and flattened epidermis. There is deposition of fibrinoid material within and around the affected lood wessels. The lesion was treated with CO2 laser effectively.