Granuloma faciale is an uncommon process that can easily be confused w
ith other skin diseases. To avoid incorrect treatment, correct diagnos
is is of primary importance. A diagnosis of granuloma faciale can be m
ade by a microscopic study of the dense granulomatous infiltrate in th
e reticular dermis with abundant polynuclear eosinophils and by an ult
rastructural study of the eosinophils, which show characteristic alter
ations in their cytoplasmatic granules. The absence of Langerhans gran
ules differentiates granuloma faciale from histiocytosis X.