Facial granuloma [IL GRANULOMA FACIALE]

Granuloma faciale is classified as a leukocytoclastic vasculitis. It typically occurs on the face as a reddish, elevated, well circumscribed, usually solitary nodule. Occasionally multiple lesions appear. The lesions are histologically characterized by a dense dermal inflammatory infiltrate separated from epidermis by a 'grenz zone' of uninvolved dermis. A case of a 50-year old man with a 3 cm nodular lesion on the chin and a papular lesion on the cheek is reported. In three years the lesions showed a very slow enlargement. No other diseases were associated. The histology was typical for granuloma faciale; an immunohistochemical study showed the presence of CD4 + CD45RO + cells with no CD4+CD45RA+ cells. This patient underwent an excision of the lesions, but after two years there was a recurrence of the lesion on the chin and two new lesions appeared on the cheek. Intralesional injection of triamcinolone (5 mg/ml) induced a regression of the lesions with no other recurrence.