An unusual presentation of granuloma faciale
Author: Anna Gkountelia
Base Hospital / Institution: BHRUT, Queen’s Hospital, Romford, UK
ePoster presentation
Abstract ID: 24-168
Purpose
This case report presents an 18-year-old, Afro-Caribbean, female, with granuloma faciale, characterized by the presence of enlarging thickened along the right lower lid margin that showed late stages of a fibrosing process with inflammation at one edge of the biopsy taken, an uncommon location for this condition. The granuloma being present for 4 years, treated as chalazion. No risk factors were identified. The goal of this case report is to increase awareness of this rare presentation of granuloma faciale and to provide guidance for its diagnosis and treatment.
Methods
The female patient was referred to the Paediatric clinic at Queen’s Hospital, Romford where examination, topical and systemic treatment with antibiotics and incisional biopsy occurred.
Results
On examination there was an enlarging thickened mass along the right lower lid margin that showed late stages of a fibrosing process with inflammation at one edge of the biopsy taken. The differential diagnoses included meibomian gland disease, chalazion, tuberculosis, Wegener’s, Sarcoidosis and lymphoma. Topical and systemic antibiotic treatment proposed, followed by incision and curettage in the past. CT orbits shown abnormal soft tissue density in the right lower eyelid, extending inferiorly to involve the subcutaneous soft tissues overlying the anterosuperior aspect of the right maxillary atrial wall. Incisional biopsy confirmed the diagnosis and the histology reported of a late stage of a chronic fibrosing leukocytoclastic vasculitis, such as what may be seen in granuloma faciale Treatment with Dapsone alongside intralesional Triamcinolone, with Sulphapyridine or Lederkyne as alternative long-acting sulphur drugs or Hydroxychloroquine considered.
Conclusion
Granuloma faciale is a chronic condition with exacerbations and remissions, spontaneous resolution is rare Lesions are often recalcitrant to treatment, subsequently many different treatment approaches have been tried, none have been reported as being reliably effective. Differential diagnosis is important in cases of persistent eyelid masses in both young patients and adults.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Wessam | Mina | BHRUT, Queen’s Hospital, Romford, UK |
| BHRUT, Queen’s Hospital, Romford, UK |
