DOI: https://doi.org/10.36347/sasjm.2026.v12i09.005

Pages: 875-878

Granulomatous rosacea (GR) is a rare, chronic inflammatory variant of rosacea characterized by its distinct histopathology and resistance to standard therapies. We report a rare case of unilateral GR in an 80-year-old male. The patient presented with a three-month history of a right-sided facial eruption, following years of isolated unilateral erythema. Clinical examination revealed purpuric papules and lupoid inflammatory nodules. Histopathology confirmed a peri-follicular lymphoplasmacytic infiltrate with non-caseating epithelioid granulomas and Demodex folliculorum. The patient showed partial improvement with oral doxycycline and topical metronidazole. This case highlights the importance of histopathological evaluation in atypical, unilateral facial dermatoses.