Infiltrated Facial Plaques With 40-Year Evolution

Area of Science:

• Dermatology
• Pathology
• Infectious Diseases

Background:

• Chronic, slowly progressive facial plaques can pose diagnostic difficulties.
• Tuberculoid granulomas on histopathology suggest specific etiological categories but require further investigation.
• Negative microbiological stains complicate the identification of infectious causes.

Purpose of the Study:

• To present a case of a chronic facial plaque with uncertain etiology.
• To highlight the diagnostic challenges in identifying the cause of granulomatous dermatoses.
• To emphasize the importance of clinicopathological correlation and follow-up.

Main Methods:

• Clinical presentation of a chronic infiltrative plaque on the nasal dorsum and malar region.
• Histopathological examination revealing a tuberculoid granulomatous process.
• Extensive microbiological investigations with negative special stains.

Main Results:

• A persistent, decades-long facial plaque was observed.
• Histopathology confirmed granulomatous inflammation, specifically tuberculoid granulomas.
• Etiology remained undetermined despite comprehensive microbiological testing.

Conclusions:

• This case underscores the diagnostic challenges posed by slowly progressive facial plaques.
• Clinicopathological correlation is crucial when microbiological studies are negative.
• Long-term follow-up is essential for managing chronic granulomatous dermatoses in endemic areas.