Granuloma faciale with extrafacial lesions

Area of Science:

• Dermatology
• Histopathology
• Inflammatory skin diseases

Background:

• Granuloma faciale is a rare chronic inflammatory skin condition.
• Typically presents as facial plaques, but can occur on the trunk.
• Previous treatments like topical steroids and cryotherapy were ineffective.

Observation:

• A 35-year-old man with a 7-year history of gradually enlarging facial and truncal plaques.
• Physical examination revealed dusky, violaceous, well-circumscribed plaques and papules.
• Histopathology showed a dense, polymorphous infiltrate in the mid and deep dermis.

Findings:

• The dermal infiltrate comprised eosinophils, lymphocytes, neutrophils, macrophages, and plasma cells.
• Leukocytoclasis, perivascular inflammation, and vascular changes were noted.
• Diagnosis confirmed as granuloma faciale with extrafacial lesions.

Implications:

• Highlights the potential for granuloma faciale to present with extrafacial involvement.
• Suggests systemic hydroxychloroquine as a potential treatment option.
• Emphasizes the importance of histopathological examination for diagnosis.