An unusual chest lesion with dual pathologies

Granuloma faciale (GF) is a rare, benign, chronic inflammatory condition characterized by well-defined reddish-brown papules, nodules, or plaques, often demonstrating follicular accentuation and telangiectasia, which may be termed "peau d'orange." Typically, GF is localized to the facial area, but extrafacial variants have been reported, particularly on the trunk, scalp, and extremities. We report a 66-year-old male with a history of GF and multiple basal cell carcinomas (BCCs) who presented with a pearly plaque on the chest. Biopsy revealed extrafacial GF with a coincidental BCC, representing a rare case of a collision tumor. GF, typically a facial condition, can present in extrafacial locations, complicating the diagnosis. This case emphasizes the importance of thorough histopathological evaluation to identify concurrent pathologies in atypical skin lesions.