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Granuloma Faciale — SCE Dermatology MCQ

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ModerateInflammatory DermatosesGranuloma FacialeSCE Dermatology

A 65-year-old man presents with granuloma faciale. He has a well-defined reddish-brown smooth plaque on his nose with prominent follicular openings. Biopsy shows a dense granulocytic infiltrate with eosinophils in the dermis, separated from the epidermis by a grenz zone. What is the first-line treatment?

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Correct answer: B — Potent topical corticosteroid or intralesional triamcinolone

Granuloma faciale is a benign chronic inflammatory condition presenting as reddish-brown smooth plaques on the face with prominent follicular openings (peau d'orange). Histologically, it shows a dense polymorphous inflammatory infiltrate rich in eosinophils, with a characteristic grenz zone (uninvolved narrow band of dermis between the epidermis and the infiltrate). First-line treatment is potent topical corticosteroids or intralesional triamcinolone. Alternatives include Dapsone, pulsed dye laser, or cryotherapy. Surgical excision has a high recurrence rate. It is a diagnosis of exclusion and must be distinguished from cutaneous lymphoma and lupus.

Reference: BAD 2019 Patient Information; BJD