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Granulomatosis disciformis chronica et progressiva L92.1

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 10.09.2026

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Synonym(s)

facial necrobiosis Miserable; Granulomatosis pseudosclerodermiformis symmetrica chronica (Gottron); Granulomatosis tuberculoides pseudosclerodermiformis; macular necrobiosis; Miescher Granulomatosis; Miescher`s granulomatosis; necrobiosis lipoidica granulomatosa

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History This section has been translated automatically.

Gottron, 1935; Miescher and Lederer, 1948

Definition This section has been translated automatically.

A controversial and apparently rare, chronic, non-necrobiotic granulomatosis whose clinical entity is the subject of debate. It is widely assumed to be a form of necrobiosis lipoidica (a milder variant of necrobiosis lipoidica).

Etiopathogenesis This section has been translated automatically.

Unknown, trauma, a diabetic metabolic state is not always present in this sepcific granulomatosis (Oliveira ARFM et al. 2017).

Manifestation This section has been translated automatically.

Middle adulthood; predominantly in women (note: the clinical data available in the literature are insufficient in this respect).

Localization This section has been translated automatically.

Mainly lower leg extension sides, back of the foot, but also described in the face and neck.

Clinic This section has been translated automatically.

Slowly centrifugally growing, 1.0-10.0 cm in size, asymptomatic, flatly raised or barely palpable, bizarrely configured, reddish-brown or light brown plaques (or spots) with partly yellowish parts; telangiectasia, atrophic surface; tendency to confluence.

Histology This section has been translated automatically.

Perivascular epithelial cell granulomas with few giant cells. In contrast to Necrobiosis lipoidica, there are hardly any necrobiosis foci.

Differential diagnosis This section has been translated automatically.

Necrobiosis lipoidica; granuloma anulare; sarcoidosis; circumscribed scleroderma.

External therapy This section has been translated automatically.

Glucocorticoid-containing external preparations (e.g. 0.1% triamcinolone cream R259 or 0.1% betamethasone ointment) and foil dressings, injection of glucocorticoid crystal suspension intrafocally (e.g. Volon A 10 mg, 1:3-1:5 diluted with the local anaesthetic scandicain). For small foci excision.

Progression/forecast This section has been translated automatically.

Mostly chronic progressive course; very rarely spontaneous healing.

Literature This section has been translated automatically.

  1. Almond-Roesler B et al. (1998) Miescher's granulomatosis disciformis. Hautarzt 49: 228–230
  2.  Bergler-Czop B et al. (2009) Miescher’s granulomatosis (granulomatosis disciformis chronica et progressiva) in a non-diabetic patient—case report. Diagn Pathol 4:28
  3. Gottron HA (1935) Symmetrical chronic pseudosclerodermiform granulomatosis (tuberculoides). Arch Dermatol Syph 172: 142
  4. Miescher G, Lederer M (1948) Chronic and progressive disciform granulomatosis (atypical tuberculosis). Dermatologica (Basel) 97: 25–34
  5. Miescher G (1949) Necrobiosis maculosa. Dermatologica (Basel) 98: 199-204

  6. Oliveira ARFM et al. (2017) Granulomatosis disciformis in a non-diabetic patient. An Bras Dermatol 92:438-439.

Authors

Last updated on: 10.09.2026

Author: Prof. Dr. med. Peter Altmeyer