ABSTRACT
El granuloma anular es una dermatosis inflamatoria granulomatosa de carácter benigno y autolimitado. El granuloma anular subcutáneo es una variante poco común, que se presenta casi exclusivamente en niños menores y se caracteriza por la aparición de nódulos de consistencia firme de predominio en extremidades inferiores, glúteos, manos y cuero cabelludo. OBJETIVO: Reportar un caso de granuloma anular subcutáneo, revisar su diagnóstico diferencial y las opciones terapéuticas actuales. CASO CLÍNICO: Paciente de sexo masculino de 4 años. Desde los 2 años y medio con nódulos subcutáneos indurados asintomáticos, inicialmente en dorso de dedo medio mano izquierda, luego en dorso de mano izquierda, primer ortejo derecho, zona frontal izquierda y cuero cabelludo. La biopsia excisional de algunas lesiones de cuero cabelludo fue compatible con granuloma anular subcutáneo. Como tratamiento se indicó clobetasol 0,05% crema 2 veces al día en lesiones por 1 mes, sin cambio en las lesiones. CONCLUSIONES: El granuloma anular subcutáneo debe considerarse dentro del diagnóstico diferencial de nódulos subcutáneos en niños. En la mayoría de los casos se requerirá biopsia y estudio histopatológico de las lesiones para su confirmación diagnóstica. Debido a su tendencia a la resolución espontánea, generalmente se sugiere no tratar y controlar periódicamente.
Granuloma annulare is a benign and self-limited cutaneous disease. Subcutaneous granuloma annulare is an uncommon variant seen almost exclusively in young children, characterized by firm nodules appearing more frequently in lower extremities, buttocks, hands and scalp. OBJECTIVE: To report a case of subcutaneous granuloma annulare and review its differential diagnoses and treatments. CLINICAL CASE: A 4 year-old male patient. Since 2 and a half years of age he presented asymptomatic firm subcutaneous nodules on the back of the left middle finger and later on the back of the left hand, right big toe, left frontal area and scalp. Excisional biopsy of some lesions from the scalp was consistent with subcutaneous granuloma annulare. Clobetasol 0,05% cream twice a day for 1 month was prescribed without response. CONCLUSIONS: Subcutaneous granuloma annulare must be considered within the differential diagnosis of subcutaneous nodules in children. In most of the cases a biopsy and histopathology of the lesions will be required to confirm the diagnosis. Due to its tendency to spontaneous resolution, treatment often is not necessary and periodic evaluation is recommended.
Subject(s)
Humans , Male , Child, Preschool , Granuloma Annulare/diagnosis , Scalp , Toes , Diagnosis, Differential , HandABSTRACT
Subcutaneous granuloma annulare(SGA) is one type of granuloma annulare that occurs mainly in children as deep dermal or subcutaneous nodule. One-forth of SGA is known to be combined with typical localized granuloma annulare. Particularly, SGA on the scalp tends to be more fixed than in other sites, it is easy to be mistaken for the malignant skin manifestation of children. We describe a 5-year-old female patient with subcutaneous and localized type granuloma annulare both on the scalp and leg. We suggest that SGA must be included in the differential diagnosis of subcutaneous nodule on the scalp in the children.
Subject(s)
Child , Child, Preschool , Female , Humans , Diagnosis, Differential , Granuloma Annulare , Granuloma , Leg , Scalp , Skin Manifestations , SkinABSTRACT
We report two cases showing typical clinical features of subcutaneous granuloma annulare. Clinically, rapidly growing non-tender subcutaneous nodules developed on the scalp of healthy children without histories of trauma or infection. Histopathologically, collagen degeneration surrounded by histiocytes and lymphocytes in a palisading arrangement were seen in the deep dermis and subcutaneous layer. The foci of degeneration contained pale and edematous basophilic mucinous deposits. The skin lesions resolved spontaneously without specific treatment. Subcutaneous granuloma annulare should be considered in the differential diagnosis of children presenting with soft tissue masses.
Subject(s)
Child , Humans , Basophils , Collagen , Dermis , Diagnosis, Differential , Granuloma Annulare , Granuloma , Histiocytes , Lymphocytes , Mucins , Scalp , SkinABSTRACT
We report herein a case of subcutaneous granuloma annulare occured in a 3-year-old girl who had 7 subcutaneous nodules on the scalp, lumbar area, buttock, right tibial area and both ankles. liistopathologically, multiple foci of complete and incomplete collagen degeneration surrounded by histiocytes in a palisading arrangement were seen in the subcutaneous layer. Some vessel walls were thickened and infiltrated with inflammatory cells and many eosinophils were scattered among the inflamrnatory cell infiltrate around the palisaiing granuloma. Five of the lesions disappeared spontaneously and other s decreased in size without specific treatment in 2 months.