[Facial granuloma. On the clinic-histologic extent of variations of finding in 5 patients].

The clinical and histopathological findings are presented in five patients with granuloma faciale. The lesions most often occur on the face and are characterized by single or multiple soft, elevated, well-circumscribed nodules or plaques ranging in color from reddish purple to brown. The sites most commonly affected are the nose, temple, checks and forehead. The etiology of granuloma faciale is unknown. The condition is extremely persistent and may last for many years. Histologically, a narrow zone of uninvolved dermis is usually observed between the epidermis and the dermal, dense, polymorphous infiltrate at all levels of the corium. The infiltrate is usually diffuse or shows a nodular perivascular pattern, consisting of lymphocytes, plasma cells, neutrophils and histiocytes together with a varying number of eosinophils. In older lesions the formation of the fibrous tissue may be seen, accompanied by capillary proliferation. Differential diagnosis includes sarcoidosis, discoid lupus erythematosus, erythema elevatum et diutinum, angiolymphoid hyperplasia with eosinophilia and histiocytosis X. The diagnosis of granuloma faciale requires a synopsis of clinical and histological findings.