A 9-year-old boy presented with a one-year history of several episodes of erythema and increased sweating on the right side of his face that appeared immediately after intense physical exercise. The skin findings were not present at the time of consultation. A photograph of one of the episodes was provided by the parent showing right hemifacial erythema (Figure 1). Physical examination, however, revealed contralateral anisocoria, miosis, mild hypochromia of the iris, ptosis measuring approximately 2 mm, as well as slight enophthalmos of the left eye ( Figure 2). These ocular features were permanent and had been present since birth. What is the diagnosis?
We present a 40-year-old woman with a one-year history of a solitary and asymptomatic facial lesion. On physical examination a slightly infiltrated, smooth red to brown nodule was seen at the left malar region. A biopsy established the diagnosis of granuloma faciale. After two-months therapy with topical tacrolimus 0,1%, nodule was resolved.
Case synopsisA 40-year-old woman presented with a one-year history of a solitary and asymptomatic facial lesion. On physical examination a slightly infiltrated, red to brown nodule was seen at the left malar region (Figure 1). The borders of the nodule were well defined; it had a smooth surface with dilated follicular ostia. The patient's medical history was unremarkable. Figure 1. Slightly infiltrated, red to brown nodule at left malar region.Histopathologic examination demonstrated, a dense, polymorphous, inflammatory cell infiltrate in the mid and deep dermis. The epidermis was spared and a Grenz zone in the upper dermis was present (Figure 2).
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