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A nose for trouble
Department of Dermatology, University of Cagliari
|How to cite this article:
Fumo G, Patta F, Milo C, Pilloni L, Atzori L. A nose for trouble. Indian J Dermatol Venereol Leprol 2015;81:93-94
A 63-year-old Caucasian non-smoker presented with purplish, firm, slowly growing plaques on the nose, of 20 years duration. The bigger one involved the upper part of the nose in its entirety [Figure - 1], while there were smaller ones on the left and right cheek. All the plaques were asymptomatic and did not worsen after sunlight exposure. His past medical history was unremarkable. Hematological and biochemical parameters were within normal limits. Histological examination revealed a diffuse mid-dermal cellular infiltrate composed of neutrophils, eosinophils, plasma cells, and lymphocytes. A narrow Grenz zone was present. In the lower part of the reticular dermis, the mixed infiltrate was intermingled with a massive deposition of fascicled pattern collagen fibers and spindle cells [[Figure - 2] and [Figure - 3]].
|Figure 1: Erythematous indurated plaque of the upper nose|
|Figure 2: A narrow Grenz zone and superficial and deep inflitrates are noted. (H and E, ×4)|
|Figure 3: The infiltrate shows many eosinophils along with neutrophils, lymphocytes and plasma cells. Fascicles of spindle cells are also seen. (H and E, ×40)|
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Thiyanaratnam J, Doherty SD, Krishnan B, Hsu S. Granuloma faciale: Case report and review. Dermatol Online J 2009;15:3.[Google Scholar]
De D, Kanwar AJ, Radotra BD, Gupta S. Extrafacial granuloma faciale: Report of a case. J Eur Acad Dermatol Venereol 2007;21:1284-6.[Google Scholar]
Tojo G, Fujimura T, Kambayashi Y, Kikuchi K, Aiba S. Successful treatment of granuloma faciale with topical tacrolimus: A case report and immunohistochemical study. Case Rep Dermatol 2012;4:158-62.[Google Scholar]
Gupta L, Naik H, Kumar NM, Kar HK. Granuloma faciale with extrafacial involvement and response to tacrolimus. J Cutan Aesthet Surg 2012;5:150-2.[Google Scholar]
Hruza GJ, Ammirati CT. Granuloma faciale treated with 595-nm pulsed dye laser. Dermatol Surg 2011;37:1060-1.[Google Scholar]
Dowlati B, Firooz A, Dowlati Y. Granuloma faciale: Successful treatment of nine cases with a combination of cryotherapy and intralesional corticosteroid injection. Int J Dermatol 1997;36:548-51.[Google Scholar]