Granuloma Faciale

Key Points
Rare skin condition, non-cancerous
Exact cause is unknown, but may be related to sun exposure
Consists of papules, nodules or plaques on the face, occurring singly and then in multiples

Granuloma faciale is a rare skin condition which is non-cancerous. It consists of papules, nodules or plaques which vary in color. Lesions may be skin-colored, blue, purple, or reddish brown, and of various sizes up to a few centimeters. Lesions will be raised and soft to the touch, and pores in the affected area will be slightly enlarged. Lesions are well defined, and generally not accompanied by other symptoms, though affected persons may experience tenderness, itching or stinging in some cases. Lesions are most commonly found on the face, but they may occur on the trunk, scalp and extremities.

The exact cause of granuloma faciale is unknown, though it is thought that it may be related to sun exposure, as the condition often appears in areas which are commonly exposed to the sun and lesions darken when exposed. It is most often seen in white men of middle-age, though it can occur in any gender, race or age group.

Differential Diagnosis (Other conditions with similar appearance)
Sarcoidosis
Cutaneous Lupus erythematosus
Polymorphous light eruption
Jessner lymphocytic infiltration
Lymphocytoma cutis
Mycosis fungoides
Insect bite reaction
Fixed drug eruption

Diagnosis
Key Points
Initial diagnosis based on appearance of the affected area
Skin biopsy will be performed to confirm diagnosis and rule out similar appearing conditions
In cases with joint pain, health care professionals may order x-rays

While granuloma faciale is initially diagnosed based on the appearance of the affected area, a skin biopsy must be performed to confirm diagnosis and to rule out other conditions with a similar appearance.

Treatment
Condition is chronic
Goal of treatment is to control and improve symptoms
No treatment is 100% effective, and the condition often recurs
Available treatments fall in to two categories, medical and surgical

Granuloma faciale is chronic in nature, and therefore affected persons will experience remissions and recurrences. The main goal of treatment is to control and improve symptom appearance, as it is not harmful or associated with other conditions. While many treatment options both surgical and medical exist, none are 100% effective, and the condition will often recur in spite of treatment.

Medical treatments include the use of topical steroids, corticosteroid Injections, dapsone, antimalarials, topical psoralen UV-A, and radiation therapy. Surgical treatments include excision, dermabrasion, laser therapy, electrosurgery, and cryotherapy. Surgical treatments may lead to scarring.