Microscopic examination of the biopsy specimen revealed a band of granulomatous inflammation in the deep reticular dermis. Small palisaded granulomas showingcollagen degeneration with focal basophilia, clusters of eosinophils, and small amounts of mucin were frequent findings. Flame figures were rare. Congestionof blood vessels was seen throughout the dermis. The subcutaneous tissue and epidermis were unremarkable.
Prednisone therapy (40 mg/d) was initiated and tapered over 3 weeks, with complete resolution of the lesions. There was still no recurrence ofthe lesions after 6 months.