RESUMO
Perforating granuloma annulare (PGA), a rare variant of granuloma annulare, is characterized by transepidermal elimination of altered collagen that clinically manifests an umbilicated papule with a central crust. It can be confused with papulonecrotic tuberculid (PNT) because of their similar appearance. Unlike PGA, PNT is usually related to tuberculosis infection with a typical histologic finding of wedge-shaped dermal necrosis. Here, we report the first Korean case of PGA mimicking PNT both clinically and histologically. A 43-year-old Korean woman presented with erythematous papules localized on the extensor surface of her limbs for one year. Some of these papules had a central umbilication or a crust. Regarding comorbidity, she had latent tuberculosis diagnosed with QuantiFERON®-TB Gold test about five months ago. She was on antituberculous medication. Initially, a diagnosis of papulonecrotic tuberculid accompanied by latent tuberculosis was considered. However, despite taking the antituberculous medication for five months, her skin lesions were not improved. Biopsy specimen from her arm lesion showed wedge-shaped area of necrosis in the dermis. Additionally, there were multiple focal mucin depositions and palisading granulomatous inflammation throughout the dermis. A diagnosis of PGA was made and she was treated with topical corticosteroid. After two weeks of applying topical corticosteroid, most of her skin lesions disappeared, leaving some hyperpigmented scars.
Assuntos
Adulto , Feminino , Humanos , Braço , Biópsia , Cicatriz , Colágeno , Comorbidade , Derme , Diagnóstico , Extremidades , Granuloma Anular , Granuloma , Inflamação , Tuberculose Latente , Mucinas , Necrose , Pele , Tuberculose , Tuberculose CutâneaRESUMO
Generalized perforating granuloma annulare is a rare variety of granuloma annulare presenting a distinct clinical pattern. We, herein, report a case of generalized perforating granuloma annulare with diabetes mellitus, which developed on a 73 year-old-female who had pruritic generalized small papular lesions with central umbilication, especially on the back and lower extremities for 1 month. Histopathologic examination showed an epidermal perforation and transepidermal elimination of necrobiotic material. The epidermal perforation was communicated with areas of necrobiotic collagen surrounded by palisading granuloma in the dermis.
Assuntos
Colágeno , Derme , Diabetes Mellitus , Granuloma Anular , Granuloma , Extremidade InferiorRESUMO
Generalized perforating granuloma annulare is a rare atypical type of granuloma annulare. It has typical clinicopathological features. We report a case of generalized perforating granuloma annulare in a 31-year-old woman. In our case, erythematous scaly and umbilicated papules were on the whole body, and histopathological finding showed that the transepidermal elimination and the deposition of degenerated collagen in the dermis with palisading granuloma.
Assuntos
Adulto , Feminino , Humanos , Colágeno , Derme , Granuloma Anular , GranulomaRESUMO
Granuloma annulare is a common, benign, inflamatory, usually self-limited dermatosis. Disseminated perforating granuloma annulare is a rare variant of granuloma annulare. A 23-month-old female patient had asymptomatic, multiple umbilicated papules on the face, limbs including palms and soles, buttock and trunk for about 5 months. The new lesions have developed with mild fever or symptoms of upper respiratory infection. Histopathological examination revealed transepidermal elimination of mucinous degenerated collagen fibers and surrounding palisading lymphohistiocytic granuloma. After she was treated with prednisolone and antibiotics, the lesions slightly resolved, but thereafter, new lesions have developed frequently with mild fever. We herein reported a rare case of disseminated perforating granuloma annulare in the youngest patient yet reported.