Dermatology: Practical and Conceptual Research Letter | Dermatol Pract Concept. 2025;15(4):5778 1 Colchicine-Responsive Granuloma Faciale: A Case Report with Dermoscopic Clues Esra Kılıç Manavlı1, Gülhan Gürel1, Burcu Belen Aydoğmuş2, Derya Aksu2 1 Department of Dermatology and Venereology, Afyonkarahisar Health Sciences University, Medicine Faculty Hospital, Turkey 2 Department of Pathology, Afyonkarahisar Health Sciences University, Medicine Faculty Hospital, Turkey Key words: Colchicine, Dermoscopy, Granuloma faciale Citation: Kılıç Manavlı E, Gürel G, Belen Aydoğmuş B, Aksu D. Colchicine-Responsive Granuloma Faciale: A Case Report with Dermoscopic Clues. Dermatol Pract Concept. 2025;15(4):5778. DOI: https://doi.org/10.5826/dpc.1504a5778 Accepted: April 22, 2025; Published: October 2025 Copyright: ©2025 Kılıç Manavlı et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Esra Kılıç Manavlı; Department of Dermatology and Venereology, Afyonkarahisar Health Sciences University, Medicine Faculty Hospital, Dörtyol Mah. 2078 Sokak, No: 3 Merkez/Afyonkarahisar, 03030, Turkey. ORCID: 0009-0002-1861-3211. Email: dresrakilic@icloud.com Introduction Granuloma faciale (GF) is a rare, benign inflammatory skin disorder characterized by red-brown or purplish papules, plaques, or nodules generally on the face [1]. The lesions are often asymptomatic and appear in middle-aged white males. The exact cause of GF is unknown. Histopathologically, GF presents with mixed dermal inflammatory infiltration, grenz zone, and vascular damage [2]. Dermoscopy has recently gained importance as a noninvasive diagnostic tool [3]. GF le- sions are chronic, and spontaneous healing is rare. The disease is very difficult to treat, and response to treatment is variable [1]. This case report presents a GF case diagnosed via dermos- copy and histopathology, successfully treated with colchicine. Case Presentation A 62-year-old male presented with a five-month history of a rash on the nose. He had previously received treatment for ro- sacea with topical metronidazole and sodium sulfacetamide without improvement. The patient had no systemic disease. Laboratory tests were normal, and the Venereal Disease Re- search Laboratory (VDRL) test was negative. At dermatolog- ical examination, an infiltrated plaque with mild violaceous erythema at the border with scales was observed on the nose. Dermoscopic examination (Dermlite DL5; 3 Gen; polarized, 10x) revealed a red-brown background with yellow follicu- lar openings, irregular white lines, linear branching vessels, brown dots/globules, and occasional scales. The histopa- thology revealed mixed-type inflammatory cell infiltration involving the entire dermis, with a grenz zone between the epidermis and dermis (Figures 1A–C). The diagnosis of GF was confirmed clinically, dermoscop- ically, and histopathologically. The patient was treated with topical steroid, tacrolimus, and systemic colchicine (twice a day). After one month, the lesion began to regress, and by the seventh month, significant improvement was observed (Figure 2). No recurrence was observed during follow-up, and the patient remains under monitoring. 2 Research Letter | Dermatol Pract Concept. 2025;15(4):5778 Conclusions A skin biopsy is necessary to differentiate GF from condi- tions like sarcoidosis, discoid lupus erythematosus, and cutaneous lymphoma [2]. Dermoscopy is a valuable, nonin- vasive method for diagnosing GF and distinguishing it from other similar conditions [3]. In 2012, Caldarola et al. de- scribed dermoscopic features of GF [4]. Typical dermoscopic findings for GF include a red-yellow-brown background, scattered brown dots and globules, mildly branching lin- ear vessels, perifollicular white halos, and dilated follicular openings. These findings correlate with histopathology, such as hemosiderin deposition and dermal infiltration [3]. The dermoscopic characteristics of our case were consistent with the literature. Additionally, the scale was more prominent. GF is usually asymptomatic but can lead to cosmetic con- cerns due to its chronic course. Common treatment options include topical tacrolimus and corticosteroids, although treatment can sometimes be challenging. Other treatments Figure 2. Significant regression of the lesions at 7th month of col- chicine treatment. Figure 1. (A) An infiltrated plaque with sharp borders and mild violaceous erythema extending from the right nasal ala to the dorsum of the nose, with desquamation at the edges. (B) Dermoscopic examination: dilated yellow follicles (red arrow) on an erythematous-brown background, scattered brown dots and globules (blue arrow), and irregular white lines (orange arrow). (C) Histopathological examination; widespread inflammation in the dermis rich in eosinophils with histiocytes arranged in a palisading pattern in the upper dermis and plasma cells, separated from the epidermis by a narrow grenz zone (H&E 200x). Research Letter | Dermatol Pract Concept. 2025;15(4):5778 3 reported include intralesional and systemic corticosteroids, topical pimecrolimus, dapsone, hydroxychloroquine, clofaz- imine, TNF-α inhibitors, laser therapy, cryotherapy, and sur- gery [1]. Colchicine, though rarely used, has shown promise in treating GF [5]; it inhibits polymorphonuclear leukocyte chemotaxis, prevents lysosome formation, and stabilizes ly- sosomal membranes, mimicking the anti-inflammatory ef- fects of dapsone [6]. Given its effectiveness and reliability, colchicine could be considered a treatment option for GF. This case contributes to the literature by providing clin- ical, dermoscopic, and histopathological findings of GF treated with colchicine. References 1. Lindhaus C, Elsner P. Granuloma faciale treatment: A sys- tematic review. Acta Derm Venereol. 2018;98(1):14-18. DOI: 10.2340/00015555-2784. PMID: 28880343. 2. Ortonne N, Wechsler J, Bagot M, Grosshans E, Cribier B. Granuloma faciale: A clinicopathologic study of 66 patients. J Am Acad Dermatol. 2005;53(6):1002-1009. DOI:  10.1016/j .jaad.2005.08.021. PMID: 16310061. 3. Tandel J, Jainendra J, Nair PA. Granuloma faciale from a der- matoscopic perspective. Clin Dermatol Rev. 2023;7(1):103-106. 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