Resolution of granuloma faciale with topical tacrolimus

Gil, Francisco; Parente, Joana; Aranha, João

doi:10.1111/ijd.14664

Cited by 3 publications

(6 citation statements)

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“…The isolated scalp involvement is very unusual, and to our knowledge there are only four cases reported in the literature. [1][2][3][4][5] Figure 1 Clinical aspect of an annular plaque of the occipital area, with raised and well-demarcated borders and a central resolution Moreover, GF usually appears as an enlarging nodule or plaque instead of an annular lesion with centrifugal growth and central clearing, as in our patient.…”

supporting

confidence: 54%

“…In one study in the National Cancer Database, an analysis of 6227 patients demonstrated that WLE with RT had improved overall survival over MMS alone after accounting for age, sex, comorbidities, primary site of lesion, and tumor size on propensity score matched analysis. 4 While the authors suggest that MMS may obviate the need for adjuvant radiation, a locoregional recurrence rate of 35.7% (20/56 primaries) was observed in their study, which could plausibly have been lower if occult nodal disease was detected and radiation was given. Although MMS has demonstrated low recurrence rates in other cutaneous neoplasms, in some investigations, this approach has resulted in local recurrence rates exceeding 20% when applied for MCC.…”

mentioning

confidence: 71%

“…3 The therapeutic outcome is often poor, and the localization in sun-exposed areas implicates an important esthetic impact on the patient. 3,4 In our case report, the diagnosis was more challenging because of the localization and the clinical presentation. The isolated scalp involvement is very unusual, and to our knowledge there are only four cases reported in the literature.…”

mentioning

confidence: 84%

“…2,3 The extrafacial GF is extremely rare and appears usually after the first facial localization, even if extrafacial isolated cases had been described. 4 Clinical differential diagnosis mainly includes sarcoidosis, deep fungal infections, and cutaneous lymphoma.…”

mentioning

confidence: 99%

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Extrafacial granuloma faciale presenting as an annular plaque of the scalp

et al. 2021

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adjuvant radiation therapy (RT) for localized disease as recommended by NCCN guidelines. 2 While patients in Terushkin et al.'s investigation did not have clinically palpable lymphadenopathy, there are no data on sentinel node status for pathologic staging, which is central to management of MCC given the high prevalence (approximately 33% across numerous studies) of occult nodal metastasis in patients with clinical N0 disease. 3 Given the lack of baseline pathologic nodal evaluation, it is unclear how the authors accurately determined nodal recurrence.The authors do not address whether there was a selection process or algorithm for choosing MMS over WLE in their clinic during this 18-year time period, introducing a possible source of bias.Evaluating the efficacy of MMS versus WLE + RT is difficult without prospective data, and retrospective studies have to control for potential confounders and selection bias, which may have influenced the outcomes of the present study, especially in the absence of head-to-head comparisons. In one study in the National Cancer Database, an analysis of 6227 patients demonstrated that WLE with RT had improved overall survival over MMS alone after accounting for age, sex, comorbidities, primary site of lesion, and tumor size on propensity score matched analysis. 4 While the authors suggest that MMS may obviate the need for adjuvant radiation, a locoregional recurrence rate of 35.7% (20/56 primaries) was observed in their study, which could plausibly have been lower if occult nodal disease was detected and radiation was given. Although MMS has demonstrated low recurrence rates in other cutaneous neoplasms, in some investigations, this approach has resulted in local recurrence rates exceeding 20% when applied for MCC. 5 Furthermore, a growing body of evidence suggests that surgical margins of at least 1 cm plus adjuvant RT compared to surgery alone are associated with improved overall survival and reduced risk of locoregional recurrence for patients with Stage I and II disease. 6,7 The study by Terushkin et al. offers a unique perspective on MMS for early stage MCC; however, given the aggressive nature of MCC with high rates of recurrence and clinically occult nodal spread, these results are unlikely to influence current guidelines which recommend SLNB and surgical excision with wide margins (>1 cm) with the addition of adjuvant radiation when larger margins are not clinically feasible.

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confidence: 54%

mentioning

confidence: 71%

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confidence: 84%

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confidence: 99%

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Extrafacial granuloma faciale presenting as an annular plaque of the scalp

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“…Therefore, the treatment of GF may be difficult. [4][5][6] Given the anti-inflammatory properties of minocycline, such as down-regulation of proinflammatory cytokine production and inhibition of neutrophil chemotaxis, we tried to evaluate the efficacy of minocycline in the treatment of GF.…”

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confidence: 99%

A Case of Granuloma Faciale Successfully Treated with Minocycline

Liu,

He,

Chang

2023

CCID

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Granuloma faciale (GF) is a rare chronic inflammatory dermatosis in clinical practice. The etiology is not yet clear, and it often occurs on the face. The progression of skin lesions is slow and persistent, with almost no self regression and a risk of recurrence, which may lead to disfigurement. We reported a 61-year-old male with GF who had poor reaction with topical corticosteroids and calcineurin inhibitors, but the lesions were significantly improved after systematic application of minocycline. This report describes the good clinical effect of minocycline on GF.

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