<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Granuloma faciale is an uncommon inflammatory skin disorder clinically characterized by single or multiple, reddishbrown nodules or plaques primarily occurring on the face of middle-aged men. Occasionally, extra-facial involvement has been reported, usually on sun-exposed areas. Although the etiology is somewhat unclear, granuloma faciale is considered a localized form of chronic leukocytoclastic vasculitis with a prominent eosinophilic infiltrate and fibrosis in the later stages of the disease. Histological examination of lesions reveals a dense polymorphous inflammatory infiltrate that consists mainly of eosinophils and neutrophils separated from the epidermis by a narrow band zone with normal collagen, deprived of cells. Leukocytoclastic vasculitis is often seen. Clinical diagnosis is suspected in few cases, so definite diagnosis of granuloma faciale requires a biopsy. The disease is notoriously resistant to many therapies and often tends to relapse after treatment is discontinued. </p><p>We present a female patient with granuloma faciale on the back and on the tip of the nose, misdiagnosed clinically as basall cell carcinoma and granuloma annulare. Her original histological diagnosis, made by a pathologist, was pyogenic granuloma. After revision of histologic findings of the biopsy specimens, granuloma faciale was diagnosed by a dermatopathologist. The treatment with cryotherapy and topical steroids was unsuccessful. Improvement of lesions was observed after use of tacrolimus 0.1% ointment, but lesion recurred after discontinuation of treatment.</p></abstract>

Granuloma faciale is an uncommon inflammatory skin disorder clinically characterized by single or multiple, reddishbrown nodules or plaques primarily occurring on the face of middle-aged men. Occasionally, extra-facial involvement has been reported, usually on sun-exposed areas. Although the etiology is somewhat unclear, granuloma faciale is considered a localized form of chronic leukocytoclastic vasculitis with a prominent eosinophilic infiltrate and fibrosis in the later stages of the disease. Histological examination of lesions reveals a dense polymorphous inflammatory infiltrate that consists mainly of eosinophils and neutrophils separated from the epidermis by a narrow band zone with normal collagen, deprived of cells. Leukocytoclastic vasculitis is often seen. Clinical diagnosis is suspected in few cases, so definite diagnosis of granuloma faciale requires a biopsy. The disease is notoriously resistant to many therapies and often tends to relapse after treatment is discontinued. We present a female patient with granuloma faciale on the back and on the tip of the nose, misdiagnosed clinically as basall cell carcinoma and granuloma annulare. Her original histological diagnosis, made by a pathologist, was pyogenic granuloma. After revision of histologic findings of the biopsy specimens, granuloma faciale was diagnosed by a dermatopathologist. The treatment with cryotherapy and topical steroids was unsuccessful. Improvement of lesions was observed after use of tacrolimus 0.1% ointment, but lesion recurred after discontinuation of treatment.

Granuloma Faciale – A Difficult Diagnosis? – A Case Report / Facijalni granulom – da li ga je teško dijagnostikovati? – Prikaz slučaja

University Clinic of Dermatology, Faculty of Medicine, University “Ss Kiril and Metodij”, Skopje, Republic of Macedonia

Serbian Journal of Dermatology and Venereology

Granuloma faciale is an uncommon inflammatory skin disorder clinically characterized by single or multiple, reddishbrown nodules or plaques primarily occurring...

Granuloma Faciale – A Difficult Diagnosis? – A Case Report / Facijalni granulom – da li ga je teško dijagnostikovati? – Prikaz slučaja

Published Online: Feb 13, 2013

Page range: 32 - 38

DOI: https://doi.org/10.2478/v10249-012-0003-x

Keywords
Granuloma, diagnosis, Skin Neoplasms, Cryosurgery, Tacrolimus, Administration, Topical, Histology

This content is open access.

Granuloma Faciale – A Difficult Diagnosis? – A Case Report / Facijalni granulom – da li ga je teško dijagnostikovati? – Prikaz slučaja

Published Online: Feb 13, 2013

Page range: 32 - 38

DOI: https://doi.org/10.2478/v10249-012-0003-x

KeywordsGranuloma, diagnosis, Skin Neoplasms, Cryosurgery, Tacrolimus, Administration, Topical, Histology

This content is open access.

Keywords
Granuloma, diagnosis, Skin Neoplasms, Cryosurgery, Tacrolimus, Administration, Topical, Histology