Introduction
Demographics
Signs and symptoms
Causes
Diagnosis
Differential diagnoses
Treatment
Outcome
Granuloma faciale is a rare, non-cancerous skin disorder that is characterised by single or multiple papules, plaques or nodules, most often occurring on the face.
Granuloma faciale most often affects healthy middle-aged white men (average onset of 52 years), although it has been found in males and females of all races and ages.
Patients most often present to their doctor after noticing a spot or lesion on their face that then enlarges or multiplies in number over several weeks or months. These lesions are usually:
Granuloma faciale is usually symptomless. Some patients may complain of tender, itching or stinging lesions.
Why granuloma faciale occurs remains unknown but sun exposure has been implicated:
Diagnosis is confirmed by skin biopsy and is often necessary to rule out other skin diseases that have similar appearance. Granuloma faciale is characterised by inflammatory cells in the dermis including eosinophils (allergy cells). There is usually a grenz zone of uninvolved upper dermis. Vascular injury due to a leukocytoclastic vasculitis (inflamed blood vessels) is usually evident. Haemosiderin may be present and indicative of extravasation of red cells due to vascular injury, giving the lesions a brown colour.
Skin conditions that may appear similar to granuloma faciale include:
Granuloma faciale is a chronic condition with exacerbations and remissions. Spontaneous resolution rarely occurs. The disease appears not to have any relationship to internal disease and treatment is mainly to improve the appearance. Various medical and surgical therapies have been used but none have been consistently successful. Granuloma faciale also has the tendency to recur after treatment.
Medical therapies used with varying results include:
Surgical therapy may also be used. Results are variable and may leave scarring.
Spontaneous resolution is uncommon and therapy is usually requested by sufferers.
