Histopathological Review on Discoid Lupus Erythematous Mimicking Granuloma Faciale

Discoid lupus erythematosus is the most common forms of chronic cutaneous lupus erythematosus. It is characterized by clinical manifestations of erythematous macules, papules, or plaques with a coin-like shape and the face is the most common predilection site. Clinical features often resemble granuloma faciale. This case report aimed to distinguish discoid lesions on the face based on the histopathological examination. A 71-year-old male with a few reddish lumps appeared on his face since three months ago. Physical examination showed multiple discrete erythematous plaques with overlying squamous. Hematoxylin and eosin staining on the epidermis demonstrated basket weave type orthokeratosis, basal vacuolar cell degeneration, epidermal atrophy with flat rete ridges, and follicular plugging while in the dermis obtained inflammatory cell infiltrates, especially in periadnexal areas. Histopathological features of DLE are hyperkeratosis, pilosebasea gland atrophy, follicular plugging, basal membrane thickening, and cellular infiltrate in periadnexa or perivascular areas more visible than in other types of CLE. In DLE, no subepidermal gren zone and eosinophil infiltrate were found, like histological features of granuloma faciale. Histopathological examination can be used to establish a diagnosis for discoid lesions on the face, although serology examination remains as the gold standart. Keywords: Discoid lupus erythematosus; Granuloma faciale; Histopathology

Successful treatment of granuloma faciale

<p class="abstract">Granuloma faciale (GF) is a chronic condition characterized by asymptomatic erythematous plaque with prominent telangiectasia presenting usually over the face. Although the condition is benign, its treatment is often unsatisfactory. Therapeutic modalities that have been tried include topical steroids and topical tacrolimus sometimes enhanced with topical dapsone. Others include intralesional corticosteroids, antimalarials, isoniazid and pulsed-dye laser. We report a case of a 58 years old female with a 1 year history of a solitary slowly progressive plaque over the nose. Diagnosis of GF was made based on the histopathological findings. The patient was started on the combination of topical tacrolimus, intralesional corticosteroids injection and oral doxycycline for 3 months. The patient showed gradual improvement in 3 months without any side effects. This case supports previous papers of successful treatment of GF with topical tacrolimus. There was no recurrence at follow-up 18 months later. It also supports the use of combination therapy especially in resistant cases.</p>

Exceptional case of a granuloma faciale with extrafacial involvement

The description of obsevation of rare dermatosis granuloma faciale is presented. Modern view about etiology, clinical picture, pathogenesis of GF is mentioned. Modern ways of treatment are considered.

Granuloma faciale – A case report

Granuloma faciale is a rare localized idiopathic inflammatory skin disorder that manifests as reddish-brown or violaceous papules, plaques, or nodules. It usually occurs in middle-aged adults and is rare in children. We are reporting a case of granuloma faciale in a 31-year-old male.