Infiltrated Facial Plaques With 40-Year Evolution.

An elderly woman presented with a chronic, infiltrative plaque on the nasal dorsum and malar region, persisting for decades. Histopathology revealed a granulomatous process, but the etiology remained uncertain despite extensive investigation. This case illustrates the diagnostic challenge of a slowly progressive facial plaque with tuberculoid granulomas and negative microbiological special stains, highlighting the importance of clinicopathological correlation and follow-up in endemic areas for chronic granulomatous dermatoses.