{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T02:04:52Z","timestamp":1772935492428,"version":"3.50.1"},"reference-count":11,"publisher":"Scientific Scholar","content-domain":{"domain":["ijdvl.com"],"crossmark-restriction":true},"short-container-title":["Indian J Dermatol Venereol Leprol"],"abstract":"\n Background<\/jats:title>\n Granulomatous skin lesions pose a diagnostic challenge due to overlapping clinical and histopathological features.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To describe the clinical and histopathological features of facial granulomatous lesions and their clinical mimics, and evaluate the utility of clinico-pathological correlation in making the final diagnosis.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a cross-sectional study including 77 patients with clinically suspected granulomatous skin lesions on the face. Diagnosis was based on clinico-pathological features, and where required, ancillary investigations and\/or therapeutic trial. Clinico-pathological correlation was classified as concordant, discordant, or non-contributory.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A definitive diagnosis could be made in 70 (91%) cases - 58 (75%) based on clinico-pathological correlation and 12 (16%) on additional ancillary investigations and\/or therapeutic trial, while 7 (9%) cases remained undiagnosed. The 70 diagnosed cases included 60 (86%) granulomatous and 10 (14%) non-granulomatous dermatoses. Orofacial granulomatosis (n=25), leprosy (n=15), and sarcoidosis (n=10) accounted for >80% of granulomatous lesions, while pseudolymphoma and lupus erythematosus (4 cases each) were the most common non-granulomatous diseases. Histopathology was concordant with clinical diagnosis in 57 (74%) cases, discordant in 8 (10%) cases, and non-contributory in 12 (16%) cases. In cases with two or more clinical differential diagnoses (n=35), histopathology aided the diagnostic decision process in 20 (57%) cases. Clinically, swellings and lip involvement favoured granulomatous lesions, while follicular plugging and nose involvement were more common in non-granulomatous lesions. Among granulomatous lesions, macules, plaques, and large (>5 cm) plaques, scaling, and forehead and nose\/peri-nasal area involvement were more common in the infectious group, while swelling and lip involvement were more common in the non-infectious group (p<0.05).<\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n A relatively small number of non-granulomatous and some granulomatous dermatoses<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Granulomatous skin lesions on the face can be a diagnostic dilemma with varied clinical morphologies and histological patterns. A small subset remains undiagnosed despite comprehensive evaluation. Though not definitive in all cases, histopathology remains a valuable diagnostic tool, particularly in clinically challenging cases. Diagnostic yield can be increased by integrating ancillary investigations and therapeutic trial.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/ijdvl_1167_2025","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:58:16Z","timestamp":1764050296000},"page":"197-205","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinically suspected granulomatous skin lesions on the face: A prospective clinico-pathological correlation study of 77 cases"],"prefix":"10.25259","volume":"92","author":[{"given":"Sushant","family":"Agrawal","sequence":"first","affiliation":[{"name":"Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ananya","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Ramam","sequence":"additional","affiliation":[{"name":"Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudheer Kumar","family":"Arava","sequence":"additional","affiliation":[{"name":"Department of Pathology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujay","family":"Khandpur","sequence":"additional","affiliation":[{"name":"Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shipra","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Pathology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binod K","family":"Khaitan","sequence":"additional","affiliation":[{"name":"Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish Datt","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Unit, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Dermatology & Venereology, All India Institute of Medical Sciences, New Delhi, 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