Granuloma anular maculoso / Patch granuloma annulare

El granuloma anular maculoso es una variante rara de granuloma anular, que representa un desafío diagnóstico. Su incidencia se desconoce y se presenta con mayor frecuencia en las mujeres de entre 40 y 70 años. Se asocia a las mismas entidades y responde a los mismos tratamientos que las otras variantes clínicas de granuloma anular. Se presentan los casos de 5 mujeres con diagnóstico de granuloma anular maculoso, que recibieron diferentes tratamientos tópicos y sistémicos, con respuestas clínicas variables.

Patch-type granuloma annulare is a rare variant of granuloma annulare, thus which represents diagnostic challenge. It has an unknown incidence and occurs most often in women between 40 and 70 years of age. It presents similar associations and responds to treatment as the clinical variants. We present 5 emale patients with patch-type granuloma annulare, who received different topical and systemic treatments, with variable clinical responses.

Granuloma anular, pronóstico de diabetes mellitus. A propósito de un caso / Annular granuloma, prognosis of diabetes mellitus. On the purpose of a case

RESUMEN El granuloma anular es una dermatosis de relativa frecuencia en niños, jóvenes y adultos. Está caracterizado por lesiones cutáneas eritemato-pápulo-nodulares, que adoptan una disposición anular. Su etiopatogenia es desconocida, pero con numerosos factores predisponentes, desencadenantes o asociados a ella; como es la diabetes mellitus y/o procesos neoplásicos o paraneoplásicos. Resulta importante el estudio de pacientes con este diagnóstico por su asociación con entidades como las antes mencionadas. Se realizó el reporte de un caso en adulto mayor de 65 años, con diagnóstico de granuloma anular, diabetes mellitus y neoplasia de páncreas.

ABSTRACT Annular granuloma is a dermatosis relatively frequent in children, young and adult people. It is characterized by erythematous-papular-nodular skin lesions adopting annular disposition. Its etio-pathogenesis is unknown, but there are many predisposal, unleashing factors, or associated to this disease, like diabetes mellitus and/or neoplastic or paraneoplastic processes. It is important to study the patients diagnosed with the disease due to its association with entities like those before mentioned. The reported case is the case of a patient elder than 65 years, diagnosed with annular granuloma, diabetes mellitus and pancreas neoplasia.

Granuloma annulare on the palms in an elderly patient

Abstract: Granuloma annulare is a relatively common, idiopathic, benign inflammatory dermatosis, with a varied clinical presentation that often makes diagnosis difficult. It mainly affects the extremities, such as the dorsa of the hands and feet, forearms and legs. Palmar and plantar regions are generally spared. It occurs mainly in young female patients. The presentation of the palmar variant in an elderly patient is a rarity.

Case for diagnosis. Patch granuloma annulare

Abstract A 59-year-old woman reported a 20-day history of slightly scaly erythematous infiltrated patches on her palms and soles with a histopathological result which was consistent with interstitial-pattern granuloma annulare, clinically classified as patch granuloma annulare. This is a rare clinical variant of granuloma annulare, with an unknown incidence and characteristic clinical and histopathological features. The patient evolved with a complete remission of the lesions after biopsy and the use of high-potency topical corticosteroid.

Monthly rifampicin, ofloxacin, and minocycline therapy for generalized and localized granuloma annulare.

Background: The localized form of granuloma annulare is usually self‑limiting, resolving within 2 years. Generalized granuloma annulare, on the other hand, runs a protracted course, with spontaneous resolution being rare. It is also characterized by a later age of onset, an increased incidence of diabetes mellitus, poor response to therapy, and an increased prevalence of HLA Bw35. Objective: To assess the efficacy of monthly pulsed rifampicin, ofloxacin, and minocycline (ROM) therapy in the management of granuloma annulare.Methods: Six biopsy proven patients of granuloma annulare were included in the study, five of the generalized variety, and one localized. Three of these patients were resistant to standard modalities of treatment. All six patients were treated with pulses of once monthly ROM till complete resolution of all lesions. Results were analyzed in terms of complete resolution of lesions and side effects. Presence of comorbid conditions was noted. Result: All six patients were successfully treated with 4-8 pulses of monthly ROM. None of the patients reported any adverse effects. Limitations: Small sample size and the lack of a control group are limitations. Conclusion: Treatment with pulses of once monthly ROM caused complete resolution of lesions in both localized and generalized granuloma annulare, even in cases recalcitrant to conventional therapy. There were no side effects in any of the patients. Larger trials are needed to substantiate the efficacy of monthly ROM in granuloma annulare.

Granuloma anular perfurante generalizado / Generalized perforating granuloma annulare

Os autores apresentam caso clínico-patológico de Granuloma Anular Perfurante Generalizado, com extensa distribuição de lesões, as quais se mostram em diversas fases de evolução. Pústulas, lesões papulosas, em distribuição anular e arciforme, erosões recobertas por crostas hemáticas, áreas máculo atróficas e cicatrizes foram as faces de apresentação da doença. Os aspectos histopatopatológicos são detalhadamente discutidos, dentro das dermatites granulomatosas não infecciosas. O texto baseia-se nas opiniões de alguns autores da literatura. Além disso, o resultado terapêutico obtido foi demonstrado por fotografias, resultado de 3 meses de Dapsona na dose de 100 mg por dia.

The authors present a clinicopathological case of Generalized Perforating Granuloma Annulare with extensive distribution of lesions, which are shown in various stages of development. Pustules, papular lesions in annular and arcuate distribution, erosions covered with hematic crusts, maculopapular atrophic areas and scars were the presentation forms of the disease. The histopathological aspects are discussed in detail within non-infectious granulomatous dermatitis. The text is based on the opinions of some authors in the literature. Furthermore, the therapeutic result obtained after three months of Dapsone at a dose of 100 mg per day was demonstrated by photographs.

Unusual presentation of granuloma annulare in periocular area

Granuloma annulare is a benign, relatively common dermatosis of childhood and young adults. Lesions typically occur on the extremities. Localized facial and periocular involvement is rare. We describe a 25- year-old woman with asymptomatic skin-color, firm, and papular lesions on both periocular areas since 6 months ago. Histological examination revealed palisading necrobiotic granuloma, characterized by an acellular central area containing mucin surrounded by palisading histiocytes, suggestive of granuloma annulare. Granuloma annulare should be considered for any acquired papular lesions of the periocular area at any age to avoid multiple surgical excisions at a later stage of life

Granuloma anular generalizado / Generalized granuloma annulare

El granuloma anular generalizado es una enfermedad inflamatoria benigna que se asocia con otras patologías. En relación a dos pacientes con diabetes mellitus y granuloma anular generalizado, se analiza su paralelismo con esta enfermedad y algunas conductas terapéuticas.

Granuloma anular elastolítico de células gigantes diseminado / Disseminated giant cell annular elastolytic granuloma

Presentamos el caso de un paciente de sexo masculino de 71 años, afectado de granuloma anular elastolítico de células gigantes diseminado. Utilizamos para su tratamiento criocirugía, obteniendo la remisión total de las lesiones. Para facilitar la comprensión de la entidad confeccionamos tablas con las características clínicas e histopatológicas de los principales diagnósticos diferenciales y con su tratamiento