Diagnosis
Pain is the most common reason for people with TMD to seek medical advice. Joint noises may require auscultation with a stethoscope to detect. Clicks of the joint may also be palpated, over the joint itself in the preauricular region, or via a finger inserted in the external acoustic meatus, which lies directly behind the TMJ. The differential diagnosis is with degenerative joint disease (e.g. osteoarthritis), rheumatoid arthritis, temporal arteritis, otitis media, parotitis, mandibular osteomyelitis, Eagle syndrome, trigeminal neuralgia, oromandibular dystonia, deafferentation pains, and psychogenic pain. Diagnostic criteria
Various diagnostic systems have been described. Some consider the Research Diagnostic Criteria method the gold standard. Abbreviated to "RDC/TMD", this was first introduced in 1992 by Dworkin and LeResche in an attempt to classify temporomandibular disorders by etiology and apply universal standards for research into TMD. This method involves 2 diagnostic axes, namely axis I, the physical diagnosis, and axis II, the psychologic diagnosis. Axis I contains 3 different groups which can occur in combinations of 2 or all 3 groups, (see table). McNeill 1997 described TMD diagnostic criteria as follows:
Pain in muscles of mastication, the TMJ, or the periauricular area (around the ear), which is usually made worse by manipulation or function. Asymmetric mandibular movement with or without clicking. Limitation of mandibular movements.
Granuloma faciale  is an uncommon benign chronic skin disease of unknown origin characterized by single or multiple cutaneous nodules, usually occurring over the face. : 836  Occasionally, extrafacial involvement is noted, most often on sun-exposed areas. Diagnosis
Skin biopsy for histopathology: 
Focal LCV, diffuse dermal neutrophilia with leukocytoclasia, tissue eosinophilia & perivascular fibrosis. Differential diagnosis
The disease mimics many other dermatoses and can be confused with conditions, such as sarcoidosis, discoid lupus erythematosus, mycosis fungoides, and fixed drug eruption. Treatment
Topical corticosteroid,
Intralesional corticosteroid,
Dapsone,
Colchicine,
Antimalarial,
Pulse dye laser,
Carbon dioxide laser. History
GF was first described in 1945 by John Edwin Mackonochie Wigley (1892–1962). See also
Cutaneous small-vessel vasculitis
List of cutaneous conditions

References


== External links ==