Granuloma Faciale Clinical Presentation

  • Author: Michael Wiederkehr, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Dec 2, 2011
 

History

  • GF is usually asymptomatic.
  • It rarely may be tender or cause itching or stinging.
  • Lesions may darken upon sun exposure.
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Physical

  • Solitary or, more commonly, multiple, soft, elevated, and well-circumscribed papules, plaques, or nodules are observed. See the images below. Solitary, well-demarcated, brown-red plaque associSolitary, well-demarcated, brown-red plaque associated with granuloma faciale. Solitary, well-demarcated, brown-red plaque associSolitary, well-demarcated, brown-red plaque associated with granuloma faciale. Solitary, well-demarcated, brown-red plaque associSolitary, well-demarcated, brown-red plaque associated with granuloma faciale. Granuloma faciale. Granuloma faciale.
  • Lesions are most commonly located over the face. Reported extrafacial locations include the scalp,[6] the trunk, and the upper and lower extremities.
  • The size of the lesions varies from a few millimeters to several centimeters in diameter.
  • The color varies from shades of dull red to brown, blue, and purple.
  • Lesions have a smooth surface with prominent follicular orifices (peau d'orange) and may be covered by telangiectases.[7]
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Causes

  • Some cases are idiopathic.
  • Production of interleukin 5 by the clonal T-cell population may cause the attraction of eosinophils to the lesions.[8]
  • A gamma interferon–mediated process has been suggested.[9]
  • Sun exposure may play a role.
    • Sunlight-exposed areas are more commonly affected than non–sun-exposed areas.
    • Lesions may darken with sunlight exposure.
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Contributor Information and Disclosures
Author

Michael Wiederkehr, MD  Consulting Staff, Livingston Dermatology Associates; Consulting Staff, Comprehensive Dermatology and Laser Center

Michael Wiederkehr, MD is a member of the following medical societies: Alpha Omega Alpha and American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Daniel J Hogan, MD  Clinical Professor of Internal Medicine (Dermatology), Nova Southeastern University College of Osteopathic Medicine; Investigator, Hill Top Research, Florida Research Center

Daniel J Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, and Canadian Dermatology Association

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Paul Krusinski, MD  Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  11. Apfelberg DB, Druker D, Maser MR, Lash H, Spence B Jr, Deneau D. Granuloma faciale. Treatment with the argon laser. Arch Dermatol. Jul 1983;119(7):573-6. [Medline].

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  34. Pinkus H. [Facial granuloma.]. Dermatologica. 1952;105(2):85-99. [Medline].

  35. Rusin LJ, Dubin HV, Taylor WB. Disseminated granuloma faciale. Arch Dermatol. Nov 1976;112(11):1575-7. [Medline].

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Solitary, well-demarcated, brown-red plaque associated with granuloma faciale.
Solitary, well-demarcated, brown-red plaque associated with granuloma faciale.
Solitary, well-demarcated, brown-red plaque associated with granuloma faciale.
Granuloma faciale.
Histologic findings in granuloma faciale.
Histologic findings in granuloma faciale.
Histologic findings in granuloma faciale.
Histologic findings in granuloma faciale.
Histologic findings in granuloma faciale.
Histologic findings in granuloma faciale include a normal epidermis; a grenz zone of uninvolved dermis just beneath the epidermis; and a dense, polymorphous inflammatory infiltrate located in the papillary and mid dermis. The infiltrate consists of neutrophils, lymphocytes, eosinophils, monocytes, and, occasionally, mast cells. Perivascular inflammation is also observed.
Histologic findings in granuloma faciale.
Multiple brown-red plaques on the face associated with granuloma faciale (same patient as in Media Files 13-16).
Multiple brown-red plaques on the nose associated with granuloma faciale (same patient as in Media Files 12 and 14-16).
Multiple brown-red plaques on the forehead associated with granuloma faciale (same patient as in Media Files 12-13 and 15-16).
Close-up view of multiple brown-red plaques on the forehead associated with granuloma faciale (same patient as in Media Files 12-14 and 16).
Close-up view of multiple brown-red plaques on the nose associated with granuloma faciale (same patient as in Media Files 12-15).
 
 
 
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