Skin inflammatory (nontumor)
Dermal perivascular and vasculopathic reaction patterns
Granuloma faciale

Author: Mowafak Hamodat, M.D., MB.CH.B, MSc., FRCPC (see Authors page)

Revised: 15 October 2018, last major update July 2011

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Granuloma faciale

Cite this page: Hamodat, M. Granuloma faciale. website. Accessed December 12th, 2018.
Definition / general
  • Mainly middle aged and older; also reported in children
  • Facial lesions resemble infected nevus, sarcoidosis and tumor
  • Also occurs on trunk
  • Recurs after surgical excision, even after full thickness grafts
Case reports
Clinical features
  • Thickened purple patches, plaques or nodules
Microscopic (histologic) description
  • Dense cellular infiltrate, often with a nodular outline, occupies the mid dermis
  • Deep dermis and subcutaneous fat may be involved
  • Typically spares the immediate subepidermis and hair follicles, forming a Grenz zone
  • Infiltrate is polymorphic, containing eosinophils, neutrophils and an admixture of plasma cells, mast cells and lymphocytes
  • Red cell extravasation is often present
  • Blood vessels appear dilated and their walls are infiltrated by eosinophils and fibrin deposition
  • Older lesions may show fibrosis and hemosiderin deposition
  • In late stage, histology resembles erythema elevatum diutinum
Positive stains
  • Granular IgG at dermal-epidermal junction; also outlines the hair follicles and walls of blood vessels
  • Less often IgA and IgM are present
Differential diagnosis
Additional references