Interstitial granulomatous dermatitis: a rare case report of dermatological manifestation of rheumatoid arthritis

Interstitial granulomatous dermatitis (IGD), a rare dermatological disorder was first described by Ackerman et al, in the year 1993. It is characterized by a heterogeneous clinical spectrum and a specific histopathological pattern. It has been described in association with a number of auto-immune disorders, drugs, fungal infections, and malignancies. It may manifest as papules, patches, plaques, nodules, annular lesions, or less frequently, as described classically, as indurated linear subcutaneous cords. This case is being reported as interstitial granulomatous dermatitis is rare dermatological manifestation of rheumatoid arthritis and presentation as large ulcerated skin lesions is further extremely rare. In this case report we describe a 67-year-old gentleman with Seropositive Rheumatoid arthritis. He presented to our hospital with complaints of multiple well defined skin lesions with pus discharge over lower limbs, trunk and upper limbs. Biopsies from left upper limb and abdomen showed focal necrobiosis with surrounding granulomatous inflammation with rare perivascular granulomas. He was subsequently diagnosed to have interstitial granulomatous dermatitis based on histopathological examination. Interstitial granulomatous dermatitis has been described to be associated with a number of autoimmune conditions and drugs. It is very important for clinicians to have knowledge about this rare skin condition as it may be heralding presentation of a serious underlying condition like lymphoproliferative disorders or solid organ malignancies. There is no specific treatment and causative disease has to be diagnosed and targeted.

Interstitial Granulomatous Dermatitis in a Patient with Prostate Cancer

Interstitial granulomatous dermatitis (IGD) is a rare dermatosis, histologically characterized by an interstitial granulomatous infiltrate. It is associated with inflammatory arthritis, various medications, and autoimmune conditions. It is also associated with malignancies such as breast, endometrial, lung, and esophageal cancers as well as hematologic malignancies such as lymphoma and myelodysplastic syndrome. Herein we describe a case of IGD associated with prostate cancer, which has not been reported in the literature.

A Case of Interstitial Granulomatous Dermatitis / 대한피부과학회지

Interstitial granulomatous dermatitis (IGD) is a rare disease that has been associated with multiple systemic diseases, particularly autoimmune conditions like rheumatoid arthritis and systemic lupus erythematosus. IGD has a variable clinical presentation and highly characteristic histological features of interstitial infiltrate of histiocytes between the degenerated collagen bundles. Here we report the case of a 63-year-old woman who presented with a 3-month history of multiple asymptomatic erythematous papules on the bilateral aspects of the trunk. A histopathological examination of the lesion showed an interstitial lymphohistiocytic infiltrate in the dermis. There were also foci of palisading histiocytes along with degenerating collagen bundles.