# Granuloma Caused by Carbon Deposition in the Dermis

Authors: Rintaro Shibuya; Yuichiro Endo; Akihiro Fujisawa; Miki Tanioka; Yoshiki Miyachi
Journal: Case Reports in Dermatological Medicine
 (2014)

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## Abstract

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.


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## Body


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