A two-year-old’s swollen eyelid led to a pencil-core granuloma diagnosis in this colourful case from Japan.

A subcutaneous induration of the patient’s left lower eyelid had been present for the past five months, which measured 2cm by the time doctors from Hiroshima examined her.

There was no sign of an entry wound, and ultrasound revealed “abundant” blood flow inside the clearly demarcated solid red growth, the doctors said.

The parents had opted against CT, MRI or biopsy because these would have required sedation, they added.