Allergic Reaction to Ear Piercing

This photo shows the earlobe of a 21 year old woman who presented to a clinic with a growing hard red nodule that was located where she had her ear pierced 5 years ago. She removed the earring after a few years because it never healed and was always inflamed.A biopsy was done of the nodule and pathology showed a skin reaction with epithelioid histiocytes surrounded by a dense infiltrate of