Treatment of granuloma faciale with steroid intralesional injection followed by a topical application of tacrolimus

Abstract

Granuloma faciale is an uncommon disease of an unknown origin, and it is characterized by single or multiple erythematous facial skin lesions. Histologically, a narrow Grenz zone of normal dermis is observed between the epidermis and the dense dermal polymorphous infiltrates. The course of granuloma faciale is chronic and the response to therapy is usually poor. We report here a case of granuloma faciale in a 37-year-old male who presented with a 13-year history of a solitary, red-brown, soft, elevated, irregular shaped plaque on me chin. The biopsy specimen showed a Grenz zone and a dense, dermal infiltrate of mononuclear cells mixed with numerous eosinophils and neutrophils that displayed a diffuse and perivascular pattern. After 4 courses of intralesional steroid injection, the lesion almost became flattened, although it remained a pinkish patch. The lesion almost cleared up after 4 months of applying 0.03% topical tacrolimus.