Successful treatment of granuloma faciale with topical tacrolimus: a case report and immunohistochemical study.

We report the case of a 55-year-old Japanese patient with granuloma faciale (GF) successfully treated with topical tacrolimus and describe the immunohistochemical study. Immunohistochemical staining revealed that the patient's granuloma contained CD3(+), CD4(+), CD8(+), CD68(+) and CD163(+) cells. Interestingly, these cells contained granulysin(+) T cells and lacked Foxp3(high+) regulatory T cells. In addition, the macrophages were mainly CD163(+), which suggested that the alternatively activated macrophage is one of the main components of GF. In summary, the present data shed light on the granuloma-composing cells and possible mechanisms in the treatment of GF with topical tacrolimus.