Multiple Agminated Papules on the Face

A middle-aged man presented with asymptomatic multiple grouped papules present bilaterally symmetrically on the face. Histopathology revealed peri-follicular, predominantly B-cell lymphoid aggregates with germinal center formation and occasional tingible body macrophages. Immunohistochemistry for Bcl-2 was positive in the peripheral mantle zone while sparing the follicle center, suggesting a reactive lymphoid follicle. Clinical differential diagnosis of facial papules can be broad, encompassing sarcoidosis, granulomatous rosacea, lupus miliaris disseminatus faciei, acneiform eruption, and eruptive benign appendageal tumors, among others. We report a rare case of pseudolymphoma clinically presenting as multiple facial papules, diagnosed through combined histopathological and immunohistochemical evaluation.