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| Fig. 15.6 Granuloma faciale demonstrating purplish indurated plaques of the nose and cheeks. (Courtesy of the Joanna Burch Collection.) |
Yes— granuloma faciale, which is an uncommon, chronic, benign, small vessel vasculitis that most commonly affects middle-aged adults. While sunexposed skin on the face is the area most commonly affected, it has also been reported to appear on extrafacial sites including the trunk and upper and lower extremities. The lesions are characteristically solitary but can be multiple. The primary lesion is a papule, nodule, or plaque that varies in size from millimeters to several centimeters (Fig. 15-6). The overlying epidermis is characteristically smooth with the follicular orifices being accentuated producing a characteristic “peau de orange” appearance. The color is highly variable and varies from yellowish to amber to brown to red to violaceous. Most lesions are asymptomatic, although occasional patients may complain of mild pruritus or burning. Once present, the lesions typically persist for years or decades, and progressive enlargement of lesions is not uncommon. The pathogenesis of this peculiar form of cutaneous vasculitis is unknown.
Thiyanaratnam J, Doherty SD, Krishnan B, Hsu S: Granuloma faciale: case report and review,
Dermatol Online J 15(12):3, 2009.
