REPORT OF A CASE
A healthy 44-year-old woman was referred for evaluation of several brownish-red papules arising on the perimeter of a full-thickness skin graft on her left cheek, placed 5 months earlier (Figure 1).
The patient recalled a small red plaque first appearing on her left cheek 6 years before this evaluation. It had been treated on four separate occasions with curettage and fulguration for presumed basal cell carcinoma, but always recurred within months of each treatment. She was ultimately referred to a surgical service for therapeutic excision.
Following a nondiagnostic punch biopsy specimen, the lesion was excised, and the 3x2-cm defect was repaired with a full-thickness skin graft. Within 4 months of excision, several brownish-red papules appeared in a ring at the periphery of the graft.
The excisional specimen was diagnostic (Figure 2 and Figure 3).
What is your diagnosis?
Figure 1.
Figure 2.
Figure 3.
DIAGNOSIS:
Granuloma
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