Skin nontumor
Dermal perivascular and vasculopathic reaction patterns
Granuloma faciale

Topic Completed: 1 July 2011

Minor changes: 29 July 2020

Copyright: 2002-2019,, Inc.

PubMed Search: Granuloma faciale

Mowafak Hamodat, M.B.Ch.B., M.Sc.
Page views in 2019: 3,222
Page views in 2020 to date: 2,015
Cite this page: Hamodat M Granuloma faciale. website. Accessed August 3rd, 2020.
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
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