Eosinophilic foreign body granuloma after multiple self-administered bee stings

A bee sting can cause a foreign body granuloma of the skin, due to activated macrophages at the stinging site. A 52-year-old woman presented with a large doughnut-shaped ulcerative tumour on the left side of her face. A bean-sized facial papule had grown to a 4.0 x 3.9 x 1.1 cm mass after multiple bee stings induced by herself over a period of 1 year. Histology showed epidermal ulceration with granulomatous inflammatory cell infiltration of many eosinophils. No micro-organisms or foreign bodies were identified. Intralesional triamcinolone acetonide was not effective, but an excellent outcome was obtained using carbon dioxide laser vaporization of the lesion.