Bari A U, Nadia Iftikhar, Simeen Ber Rahman.
Granuloma Faciale treated with cryotherapy.
J Pak Assoc Derma Jan ;12(4):211-4.

A 53 years old, otherwise healthy male presented with three months history of gradually progressing asymptomatic dark brown to purple coloured plaques over his face, involving mostly the nose and the malar regions. The lesions became static during last one month. He applied various topical medications including potent topical steroids but the lesions did not show any regression. One of the lesions was biopsied and histopathology turned out to be of granuloma faciale with a subepidermal (Grenz) zone and a dense inflammatory infiltration of the superficial and mid derma around dilated vessels under a normal epidermis. The infiltrate was composed of eosinophils, neutrophils, histiocytes, lymphocytes and plasma cells. We intended to treat this condition with dapsone but the patient was found to be deficient with glucose 6-phosphate dehydrogenase enzyme (G6PD). So we started treating him with liquid nitrogen that was applied once weekly on the lesions for about 15-20 seconds contact time. The lesions started regressing in size and were substantially cleared after two month of therapy.

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