Granuloma faciale - Skin
L92.2 – Granuloma faciale [eosinophilic granuloma of skin]
61137005 – Granuloma faciale
- Lymphoma – Particularly, B-cell lymphoma may also present as an erythematous to violaceous nodule upon the head and neck of older individuals.
- Pseudolymphoma / lymphocytoma cutis – A reactive infiltration of inflammatory cells that recapitulate nodal lymphoid tissue; the ear is a particularly common location for lymphocytoma and is an unusual location for granuloma faciale.
- Tumid lupus – Commonly presents on the sun-exposed face, neck, and upper chest and presents with areas of erythema and induration, but no follicular plugging.
- Polymorphous light eruption – Polymorphous lesions present 1-4 days after exposure to sunlight, and the condition is worse in the spring. A photodistribution including the V of the neck, hands, and arms is common; the face is usually spared.
- Fixed drug eruption – Presents as a plaque, often with central vesiculation, and the condition recurs in the same "fixed" area upon repeated exposure to the same causative agent.
Note: Extrafacial grauloma faciale may be very similar, clinically and histologically, to erythema elevatum diutinum (EED), and some authors consider them the same disease in different locations. Histologically, EED typically lacks a Grenz zone and may have prominent lipid-laden macrophages and often a more overt vasculitis.
Pediatric Patient Considerations: In children, where grauloma faciale is extremely rare, the differential diagnosis includes the following:
- Juvenile xanthogranuloma – Presents as an asymptomatic smooth and round yellow, red, or brown papule(s) upon the head and neck.
- Mastocytoma – Presents as orange to brown papules or patches that blister with manipulation or other events that cause mast cell degranulation.
- Spitz nevus – Dome-shaped red or pigmented papules or nodules without follicular plugging; Spitz nevi usually present with a period of rapid initial growth and then stabilization in size.)