**1. Introduction**

The granuloma is the result of interplay of an invading organism or antigen, chemical, drug or other irritant, prolonged antigenemia, macrophage activity, a Th1 cell response, B cell overactivity, circulating immune complexes, and a vast array of biological mediators [1]. Cutaneous granulomatosis can be localized or more disseminated, depending on their etiology. The typical lesion is a painless infiltrated papule, rounded, well limited, and reddish-pink and takes a yellowish color on diascopy, called apple-jelly. Its surface is smooth or slightly squamous, as there is generally no epidermal participation [2]. From a clinical point of view, it is useful to divide cutaneous granulomatosis into localized and more disseminated forms, although this distinction may sometimes be artificial. From a pathogenic point of view, they are divided into noninfectious and infectious granulomas [3].
