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Case Report
Medwave 2019;19(11):e7740 doi: 10.5867/medwave.2019.11.7740
A case report of granuloma faciale, an uncommon cutaneous vasculitis
Javier Arellano, Pablo Vargas, Constanza Pulgar, Gabriel Neely, Yamile Corredoira
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Key Words: granuloma, facial dermatoses, vasculitis

Abstract

Granuloma faciale is an uncommon benign dermatosis, with unknown etiology, usually asymptomatic, characterized by chronic inflammation localized in sun-exposed areas of the face with a characteristic histological pattern. Although response to treatment is variable, there are multiple therapeutic alternatives that have been reported to be effective in some patients, including systemic treatments with steroids and dapsone or also topical treatments like intralesional corticosteroid, cryotherapy and calcineurin inhibitors, such as tacrolimus. We present the case of an adult patient with an asymptomatic erythematous-violet plaque on the right cheek, with progressive slow growth over two years, clinically and histologically and pathologically compatible with a facial granuloma. The patient responded well to intralesional corticosteroids.


 

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El granuloma facial es una dermatosis benigna poco frecuente de etiología desconocida, generalmente asintomática, caracterizada por inflamación crónica y localizada habitualmente en zonas fotoexpuestas de la cara, con un patrón histológico característico. Si bien la respuesta al tratamiento es variable, existen múltiples opciones terapéuticas que han reportado ser efectivas en algunos pacientes. Entre estas alternativas se incluyen tratamientos sistémicos con corticoides y dapsona o tratamientos intralesionales con corticoides, crioterapia e inhibidores de calcineurina tópicos. Describimos el caso de un paciente adulto con una placa eritemato violácea asintomática en mejilla derecha, de crecimiento lentamente progresivo de dos años de evolución, clínica e histopatológicamente compatible con granuloma facial y respuesta favorable a corticoides intralesionales.

Authors: Javier Arellano[1,2], Pablo Vargas[2], Constanza Pulgar[1], Gabriel Neely[3], Yamile Corredoira[4]

Affiliation:
[1] Servicio de Dermatología, Hospital Clínico San Borja Arriarán, Santiago, Chile
[2] Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
[3] Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
[4] Servicio de Anatomía Patológica, Hospital Clínico San Borja Arriarán, Santiago, Chile

E-mail: pablovargas.med@gmail.com

Author address:
[1] Santos Dumont 999
Independencia
Santiago
Chile

Citation: Arellano J, Vargas P, Pulgar C, Neely G, Corredoira Y. A case report of granuloma faciale, an uncommon cutaneous vasculitis. Medwave 2019;19(11):e7740 doi: 10.5867/medwave.2019.11.7740

Submission date: 20/5/2019

Acceptance date: 28/10/2019

Publication date: 6/12/2019

Origin: not commissioned

Type of review: reviewed by three external peer reviewers, double-blind

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  1. Peckruhn M, Elsner P, Tittelbach J. Eosinophilic dermatoses. J Dtsch Dermatol Ges. 2019 Oct;17(10):1039-1051. | CrossRef | PubMed |
  2. Al Dhafiri M, Kaliyadan F. Granuloma Faciale. en: StatPearls.Treasure Island (FL): StatPearls Publishing; 2019 Jan.[on line]. | Link |
  3. Ortonne N, Wechsler J, Bagot M, Grosshans E, Cribier B. Granuloma faciale: a clinicopathologic study of 66 patients. J Am Acad Dermatol. 2005 Dec;53(6):1002-9. | PubMed |
  4. Oliveira CC, Ianhez PE, Marques SA, Marques ME. Granuloma faciale: clinical, morphological and immunohistochemical aspects in a series of 10 patients. An Bras Dermatol. 2016 Nov-Dec;91(6):803-807. | CrossRef | PubMed |
  5. Radin DA, Mehregan DR. Granuloma faciale: distribution of the lesions and review of the literature. Cutis. 2003 Sep;72(3):213-9; quiz 208. | PubMed |
  6. Teixeira DA, Estrozi B, Ianhez M. Granuloma faciale: a rare disease from a dermoscopy perspective. An Bras Dermatol. 2013 Nov-Dec;88(6 Suppl 1):97-100. | CrossRef | PubMed |
  7. Marcoval J, Moreno A, Peyr J. Granuloma faciale: a clinicopathological study of 11 cases. J Am Acad Dermatol. 2004 Aug;51(2):269-73. | PubMed |
  8. Deen J, Moloney TP, Muir J. Extrafacial Granuloma Faciale: A Case Report and Brief Review. Case Rep Dermatol. 2017 Jul 13;9(2):79-85. | CrossRef | PubMed |
  9. Lallas A, Argenziano G, Apalla Z, Gourhant JY, Zaballos P, Di Lernia V, et al. Dermoscopic patterns of common facial inflammatory skin diseases. J Eur Acad Dermatol Venereol. 2014 May;28(5):609-14. | CrossRef | PubMed |
  10. Jardim MML, Uchiyama J, Kakizaki P, Valente NYS. Dermoscopy of granuloma faciale: a description of a new finding. An Bras Dermatol. 2018 Jul-Aug;93(4):587-589. | CrossRef | PubMed |
  11. Kaur M, Singh A, Ramesh V. Granuloma faciale. Indian Dermatol Online J. 2016 Mar-Apr;7(2):130-2. | CrossRef | PubMed |
  12. Lindhaus C, Elsner P. Granuloma Faciale Treatment: A Systematic Review. Acta Derm Venereol. 2018 Jan 12;98(1):14-18. | CrossRef | PubMed |
  13. Dowlati B, Firooz A, Dowlati Y. Granuloma faciale: successful treatment of nine cases with a combination of cryotherapy and intralesional corticosteroid injection. Int J Dermatol. 1997 Jul;36(7):548-51. | PubMed |
  14. Ohata C, Nakama T. Granuloma Faciale Treated Successfully with Colchicine. Acta Derm Venereol. 2019 Jul 1;99(9):833-834. | CrossRef | PubMed |
  15. Madan V. Recurrent granuloma faciale successfully treated with the carbon dioxide laser. J Cutan Aesthet Surg. 2011 May;4(2):156-7. | CrossRef | PubMed |
  16. Morgado-Carrasco D, Giavedoni P, Mascaró JM Jr, Iranzo P. Assessment of Treatment of Refractory Granuloma Faciale With Intralesional Rituximab. JAMA Dermatol. 2018 Nov 1;154(11):1312-1315. | CrossRef | PubMed |
Peckruhn M, Elsner P, Tittelbach J. Eosinophilic dermatoses. J Dtsch Dermatol Ges. 2019 Oct;17(10):1039-1051. | CrossRef | PubMed |

Al Dhafiri M, Kaliyadan F. Granuloma Faciale. en: StatPearls.Treasure Island (FL): StatPearls Publishing; 2019 Jan.[on line]. | Link |

Ortonne N, Wechsler J, Bagot M, Grosshans E, Cribier B. Granuloma faciale: a clinicopathologic study of 66 patients. J Am Acad Dermatol. 2005 Dec;53(6):1002-9. | PubMed |

Oliveira CC, Ianhez PE, Marques SA, Marques ME. Granuloma faciale: clinical, morphological and immunohistochemical aspects in a series of 10 patients. An Bras Dermatol. 2016 Nov-Dec;91(6):803-807. | CrossRef | PubMed |

Radin DA, Mehregan DR. Granuloma faciale: distribution of the lesions and review of the literature. Cutis. 2003 Sep;72(3):213-9; quiz 208. | PubMed |

Teixeira DA, Estrozi B, Ianhez M. Granuloma faciale: a rare disease from a dermoscopy perspective. An Bras Dermatol. 2013 Nov-Dec;88(6 Suppl 1):97-100. | CrossRef | PubMed |

Marcoval J, Moreno A, Peyr J. Granuloma faciale: a clinicopathological study of 11 cases. J Am Acad Dermatol. 2004 Aug;51(2):269-73. | PubMed |

Deen J, Moloney TP, Muir J. Extrafacial Granuloma Faciale: A Case Report and Brief Review. Case Rep Dermatol. 2017 Jul 13;9(2):79-85. | CrossRef | PubMed |

Lallas A, Argenziano G, Apalla Z, Gourhant JY, Zaballos P, Di Lernia V, et al. Dermoscopic patterns of common facial inflammatory skin diseases. J Eur Acad Dermatol Venereol. 2014 May;28(5):609-14. | CrossRef | PubMed |

Jardim MML, Uchiyama J, Kakizaki P, Valente NYS. Dermoscopy of granuloma faciale: a description of a new finding. An Bras Dermatol. 2018 Jul-Aug;93(4):587-589. | CrossRef | PubMed |

Kaur M, Singh A, Ramesh V. Granuloma faciale. Indian Dermatol Online J. 2016 Mar-Apr;7(2):130-2. | CrossRef | PubMed |

Lindhaus C, Elsner P. Granuloma Faciale Treatment: A Systematic Review. Acta Derm Venereol. 2018 Jan 12;98(1):14-18. | CrossRef | PubMed |

Dowlati B, Firooz A, Dowlati Y. Granuloma faciale: successful treatment of nine cases with a combination of cryotherapy and intralesional corticosteroid injection. Int J Dermatol. 1997 Jul;36(7):548-51. | PubMed |

Ohata C, Nakama T. Granuloma Faciale Treated Successfully with Colchicine. Acta Derm Venereol. 2019 Jul 1;99(9):833-834. | CrossRef | PubMed |

Madan V. Recurrent granuloma faciale successfully treated with the carbon dioxide laser. J Cutan Aesthet Surg. 2011 May;4(2):156-7. | CrossRef | PubMed |

Morgado-Carrasco D, Giavedoni P, Mascaró JM Jr, Iranzo P. Assessment of Treatment of Refractory Granuloma Faciale With Intralesional Rituximab. JAMA Dermatol. 2018 Nov 1;154(11):1312-1315. | CrossRef | PubMed |