ABSTRACT
OBJECTIVE: To determine the clinical manifestations, management, and outcomes of pediatric granuloma annulare (GA). STUDY DESIGN: We searched MEDLINE via PubMed, Latin American and Caribbean Health Sciences, and EMBASE from inception to January 2021. We included all original reports of patients <18 years of age with a diagnosis of GA and all original reports describing any intervention, including topical or systemic agents, in these patients. Two authors independently extracted sociodemographics and clinical data of the study patients and treatment(s) used. RESULTS: Of 2440 reports screened, 202 were included (836 patients). The mean age was 5.7 (SD 3.8) years and F:M ratio 1.3:1. Localized GA (n = 384/821, 46.8%) and subcutaneous GA (n = 353/821, 43.0%) were the most prevalent subtypes. The most affected site was lower limbs (n = 272/568, 47.9%). Suspected triggering factors were mainly local trauma. Diabetes was associated in 22 (2.6%) patients. The rate of spontaneous remission was high (n = 140/155, 90.3%), with a median time of 12 months. The most frequent therapies were surgery and topical corticosteroids. Recurrence was observed in 38.3% (n = 168/439) of patients, regardless of treatment. CONCLUSIONS: Pediatric GA frequently resolves spontaneously yet displays a high recurrence rate. Hence, in asymptomatic forms, invasive therapies are not recommended as first-line treatment.
Subject(s)
Diabetes Mellitus , Granuloma Annulare , Humans , Child , Child, Preschool , Granuloma Annulare/therapy , Granuloma Annulare/drug therapy , Glucocorticoids/therapeutic use , Remission, Spontaneous , Diagnosis, DifferentialABSTRACT
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.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged, 80 and over , Granuloma Annulare/diagnosis , Phototherapy , Granuloma Annulare/pathology , Granuloma Annulare/drug therapy , Octogenarians , NonagenariansABSTRACT
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.
Subject(s)
Humans , Male , Aged , Pancreatic Neoplasms/surgery , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/mortality , Granuloma Annulare/classification , Granuloma Annulare/complications , Granuloma Annulare/diagnosis , Granuloma Annulare/etiology , Granuloma Annulare/pathology , Granuloma Annulare/drug therapy , Glyburide/therapeutic use , Diabetes Mellitus/diagnosis , Diabetes Mellitus/etiology , Diabetes Mellitus/drug therapy , Insulin/therapeutic use , Skin/injuries , Follow-Up Studies , Medical History Taking , Nevus/diagnosisABSTRACT
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.
Subject(s)
Humans , Female , Middle Aged , Granuloma Annulare/pathology , Hand Dermatoses/pathology , Clobetasol/administration & dosage , Granuloma Annulare/drug therapy , Glucocorticoids/administration & dosage , Hand Dermatoses/drug therapyABSTRACT
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.
Subject(s)
Granuloma Annulare/pathology , Hand Dermatoses/pathology , Clobetasol/administration & dosage , Female , Glucocorticoids/administration & dosage , Granuloma Annulare/drug therapy , Hand Dermatoses/drug therapy , Humans , Middle AgedABSTRACT
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.
Subject(s)
Granuloma Annulare/pathology , Administration, Topical , Adrenal Cortex Hormones/administration & dosage , Female , Granuloma Annulare/drug therapy , Humans , Middle AgedABSTRACT
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.
Subject(s)
Humans , Female , Middle Aged , Granuloma Annulare/pathology , Administration, Topical , Granuloma Annulare/drug therapy , Adrenal Cortex Hormones/administration & dosageABSTRACT
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.
Subject(s)
Anti-Infective Agents/therapeutic use , Dapsone/therapeutic use , Granuloma Annulare/pathology , Skin Diseases/pathology , Granuloma Annulare/drug therapy , Humans , Male , Middle Aged , Skin Diseases/drug therapyABSTRACT
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.
Subject(s)
Humans , Male , Middle Aged , Anti-Infective Agents/therapeutic use , Dapsone/therapeutic use , Granuloma Annulare/pathology , Skin Diseases/pathology , Granuloma Annulare/drug therapy , Skin Diseases/drug therapyABSTRACT
We report two cases of adverse cutaneous reactions following hepatitis B vaccination. The first case occurred 3 weeks after the first dose of hepatitis B vaccine in a 16-year-old white girl with the onset of lichen planus lesions on her thighs and abdomen. After the second dose a disseminated lichen planus developed within 2 weeks. The second case concerns to the development of papular and patch granuloma annulare in a 58-year-old white woman 2 months after the second dose of hepatitis B vaccine. To the best of our knowledge, only a few paediatric and adult cases of lichen planus as a complication of hepatitis B vaccination have been reported in medical literature so far. This is the second case of granuloma annulare following hepatitis B vaccine. Our report, similar to earlier papers, appears to support the onset of lichen planus and granuloma annulare as a possible rare complication of hepatitis B immunization.
Subject(s)
Drug Eruptions/diagnosis , Granuloma Annulare/diagnosis , Hepatitis B Vaccines/adverse effects , Lichen Planus/diagnosis , Administration, Cutaneous , Administration, Oral , Adolescent , Anti-Inflammatory Agents/administration & dosage , Desonide/administration & dosage , Diagnosis, Differential , Drug Eruptions/drug therapy , Drug Eruptions/pathology , Female , Granuloma Annulare/drug therapy , Granuloma Annulare/pathology , Humans , Leg , Lichen Planus/drug therapy , Lichen Planus/pathology , Metronidazole/administration & dosage , Middle AgedABSTRACT
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.
Subject(s)
Humans , Male , Female , Dermatologic Agents/therapeutic use , Diabetes Mellitus/complications , Granuloma Annulare/complications , Granuloma Annulare/etiology , Granuloma Annulare/drug therapyABSTRACT
El granuloma actínico (GA) fue descrito por J. P. OBrien en 1975 como un fenómeno de reparación del tejido conectivo elastótico dañado por el sol o el calor. Realizó una minuciosa descripción histológica, afirmando que se trata de una entidad relacionada con el granuloma anular, pero con características propias que permiten distinguirlo de otros granulomas. A partir de entonces se generó una polémica sobre su existencia como entidad independiente. El GA tiene características clínico-histológicas singulares, no siempre específicas y claramente reproducibles. Presentamos cinco casos de GA, efectuamos una revisión del tema y ubicamos a ésta entidad como una variante del granuloma anular (AU)
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aged , Granuloma Annulare/pathology , Granuloma Annulare/complications , Granuloma Annulare/diagnosis , Granuloma Annulare/drug therapy , Sunlight/adverse effects , Triamcinolone Acetonide/therapeutic use , Dapsone/therapeutic useABSTRACT
Se presenta un caso de granuloma anular elastolítico a células gigantes en un paciente de sexo masculino de 78 años de edad. El objetivo de nuestro trabajo es facilitar la comprensión de la entidad y ayudar a realizar el diagnóstico diferencial con otros cuadros clínica y/o histopatológicamente semejantes (AU)
Subject(s)
Humans , Male , Aged , Granuloma Annulare/diagnosis , Granuloma Annulare/drug therapy , Granuloma Annulare/pathology , Elastic Tissue/pathology , Giant CellsABSTRACT
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
Subject(s)
Humans , Male , Aged , Granuloma Annulare/diagnosis , Necrobiosis Lipoidica/diagnosis , Cryosurgery , Diagnosis, Differential , Granuloma Annulare/drug therapy , Granuloma Annulare/surgery , Necrobiosis Lipoidica/drug therapy , Necrobiosis Lipoidica/surgeryABSTRACT
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 (AU)