Treatment of granuloma faciale in adults

G6PD: glucose-6-phosphate dehydrogenase.

* Topical tacrolimus is our preferred initial treatment based on a low likelihood of cosmetically significant adverse effects.

¶ We generally reserve topical corticosteroids for patients who cannot tolerate or decline intralesional corticosteroid therapy. Cutaneous atrophy is a risk of corticosteroid treatment. Risks of cryotherapy include dyspigmentation and scarring.

• Intralesional injections of triamcinolone acetonide (concentration of 3 mg/mL) are administered every 4 to 6 weeks and discontinued if there is no response after 3 treatments.
• A high-potency corticosteroid is applied twice daily for 2 weeks and then switched to a low-potency corticosteroid. We discontinue topical corticosteroids if there is no response within 2 to 3 months.
• Cryotherapy is performed every 4 to 6 weeks. We stop cryotherapy if there is a poor response after 3 to 4 treatments.

Δ Screening for G6PD deficiency should be performed prior to starting dapsone. Patients with G6PD deficiency have an increased risk for hematologic complications from dapsone. Refer to UpToDate content on granuloma faciale for details on dapsone and other treatments.