Extrafacial granuloma faciale – case report

Introduction. Granuloma faciale is a rare, chronic disease. It is characterized by the presence of brownish papules, nodules and infiltrated plaques usually on the face. The occurrence of lesions in other body regions – extrafacial granuloma faciale – is very uncommon.
Objective. The aim of this paper is to present a patient with granuloma faciale occurring only extrafacially.
Case report. In the 56-year-old patient, small, brownish, asymptomatic nodules and round infiltrations of 1-4 cm in diameter had been appearing for the last 15 years. The lesions were located on the patient’s back, arm, abdomen and behind the left ear. Differential diagnosis with cutaneous lymphoma, lymphocytoma, Kaposi’s sarcoma and sarcoidosis was necessary. Histopathological examination was consistent with granuloma faciale and the diagnosis of extrafacial granuloma faciale was established. After 6 months of treatment with systemic dapsone and topical tacrolimus all lesions disappeared, leaving only hyperpigmentations.
Conclusions. In differential diagnosis of chronic skin lesions consisting of brownish papules, nodules and infiltrated plaques, independently of their location, extrafacial granuloma faciale should always be taken into consideration. In the diagnosis skin biopsy plays the basic role. Systemic dapsone and topical tacrolimus give positive therapeutic effects.