Granuloma caused by carbon deposition in the dermis.
Pencil core granuloma is characterized by a delayed foreign-body reaction against retained fragments of pencil lead. Previous case reports presented pencil core granuloma resembling malignant melanoma, haemangioma, or soft tissue sarcoma. We present a case of pencil core granuloma arising from the palm 25 years after the initial injury. The patient presented a bluish nodule that had been present over 25 years before. The nodule initially measured 5 mm in diameter. However, five years before presentation, it suddenly enlarged to the size of 30 mm during six months. Computed tomography (CT) of the lesion revealed a linear radiopaque structure of 8 mm long with a mass on its distal end. Surgical resection revealed a bluish muddy mass and pencil lead. Histological examination revealed degenerative tissue with calcification surrounded by massive amounts of black granular material in the middle and lower dermis.
Department of Dermatology, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Rintaro
0000-0003-3805-2562
R
Shibuya
Department of Dermatology, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Yuichiro
Y
Endo
Department of Dermatology, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Akihiro
0000-0002-8840-7512
A
Fujisawa
Department of Dermatology, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Miki
M
Tanioka
Department of Dermatology, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Yoshiki
Y
Miyachi