Granuloma faciale—treatment by dermabrasion

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GRANULOMA faciale is characterized by reddish-brown elevated plaques or nodules with follicular plugging which develop mainly on the face.1 Although the lesions are asymptomatic and have never been associated with systemic disease, they are frequently cosmetically distressing. In the past there has been no form of treatment that has produced consistently good results. We are reporting a case of granuloma faciale in a young Negro woman in whom a good cosmetic result was obtained by dermabrasion.

Report of a case

A 31-year-old woman was first seen at the Cleveland Clinic in April 1968 because of nodular lesions on her nose, cheeks, and ears, of four years' duration (Fig. 1). A biopsy specimen showed a dense granulomatous reaction in the dermis with perivascular infiltrate composed of histiocytes, eosinophils, many neutrophils, and leukocytoclasis. The pilosebaceous appendages were well preserved. The epidermis and subcutaneous tissue were not involved. The biopsy specimen was consistent histologically with granuloma faciale.

In May 1968 the patient was started on a course of intralesional triamcinolone therapy. Treatments were given at two- to four-week intervals for six months with triamcinolone acetonide from 0.5 to 2 mg per infiltrate at each treatment. Initially there was no improvement. In October 1968 a trial of antimalarial therapy (hydroxychloroquine sulfate 200 mg per day) was started, and the monthly intralesional injections of triamcinolone were discontinued. After six months of this therapy, minimal flattening of the nodules was noted (Fig. 2). A second skin biopsy of the facial lesions in July 1969 showed only . . .



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