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    Deep Granuloma Annulare Mimicking Inflamed Cysts in a Teenager.
    Pediatr Dermatol 2017 Apr 17. Epub 2017 Apr 17.
    Department of Dermatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
    We describe deep granuloma annulare (DGA) of the forehead mimicking inflamed cysts. Reactive inflammation and sterile purulent drainage may be an underrecognized feature of DGA. Read More

    Cutaneous Manifestations of Diabetes Mellitus: A Review.
    Am J Clin Dermatol 2017 Apr 3. Epub 2017 Apr 3.
    Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.
    Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Read More

    Borderline Tuberculoid Leprosy Masquerading as Granuloma Annulare: A Clinical and Histological Pitfall.
    Am J Dermatopathol 2017 Apr;39(4):296-299
    *Keck School of Medicine, University of Southern California, Los Angeles, CA; andDepartments of †Dermatology, and‡Pathology and Laboratory Medicine, University of California Davis School of Medicine, Sacramento, CA.
    Introduction: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, an intracellular acid-fast bacillus that tends to infect the skin and peripheral nerves. Because of the wide array of cutaneous manifestation, diagnosis is not always straightforward, especially in nonendemic regions of the world such as the United States.

    Case Report: The authors report an unusual case of borderline tuberculoid leprosy in an 80-year-old white woman from California. Read More

    Chronic Hepatitis with Liver Granulomas in a Patient with Granuloma Annulare: A Case Report and Review of the Literature.
    Case Rep Gastrointest Med 2017 23;2017:8768529. Epub 2017 Feb 23.
    Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada.
    Granuloma annulare (GA) is a benign granulomatous skin disorder of unknown etiology. GA is rarely associated with liver diseases. We report a unique case of chronic hepatitis with liver granulomas in a patient with GA. Read More

    What is new in the histogenesis of granulomatous skin diseases?
    J Dermatol 2017 Mar;44(3):297-303
    Department of Dermatology, Kyoto prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
    A granuloma is a form of inflammation, which predominantly consists of macrophages. It typically develops when the immune system attempts to enclose substances that are usually insoluble and cannot be eliminated to prevent the spread of these substances to the other body compartments. According to the source of the substances, granulomatous diseases can be divided into two groups: infectious and non-infectious. Read More

    Actinic Granuloma Annulare With Scarring and Open Comedones.
    Am J Dermatopathol 2017 Feb 14. Epub 2017 Feb 14.
    *Department of Dermatology, Medical School, University of São Paulo, São Paulo, Brazil; and †Department of Pathology, Hospital Obrero, La Paz, Bolivia.
    Actinic granuloma and annular elastolytic giant cell granuloma are variants of granuloma annulare affecting, respectively, sun-exposed and sun-covered skin sites on where, besides classical findings, abundant elastophagocytosis is observed. Here, we report a case of exuberant actinic granuloma annulare that, in addition to extensive scarring, showed multiple overlying open comedones. Markedly dilated follicular infundibula filled with compact masses of laminated keratinous material were observed in proximity to dermal inflammation composed of many histiocytes and multinucleated giant cells in close association with degenerated elastic fibers and abundant elastophagocytosis. Read More

    Diabetes mellitus and the skin.
    An Bras Dermatol 2017 Jan-Feb;92(1):8-20
    Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) -Botucatu (SP), Brazil.
    Several dermatoses are routinely associated with diabetes mellitus, especially in patients with chronic disease. This relationship can be easily proven in some skin disorders, but it is not so clear in others. Dermatoses such necrobiosis lipoidica, granuloma annulare, acanthosis nigricans and others are discussed in this text, with an emphasis on proven link with the diabetes or not, disease identification and treatment strategy used to control those dermatoses and diabetes. Read More

    Dermoscopy of Granuloma Annulare: A Clinical and Histological Correlation Study.
    Dermatology 2017 Jan 19. Epub 2017 Jan 19.
    Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.
    Background: Dermoscopy of granuloma annulare has been investigated by several studies, but none of them took into account the variability of dermoscopic findings according to clinical characteristics and/or histological subtype.

    Objective: To describe the dermoscopic features of classic granuloma annulare and seek possible dermoscopic clues related to specific clinical findings/histological subpatterns.

    Methods: A representative dermoscopic image of a target lesion (the most active lesion underwent histological examination) was retrospectively assessed for the presence of specific morphological findings, correlating them with clinical variables, i. Read More

    Disseminated eruptive granuloma annulare induced by levetiracetam.
    Cutan Ocul Toxicol 2017 Jan 17:1-2. Epub 2017 Jan 17.
    c Neurology, Abant Izzet Baysal Universitesi , Bolu , Turkey.
    Granuloma annulare (GA) is a benign, granulomatous cutaneous disease without clear etiology. Disseminated and drug induced granuloma annulare is a rare presentation. We present a 47-year-old woman with diffuse circular erythematous eruptions following treatment with levetiracetam. Read More

    Granulomatous & histiocytic dermatitides.
    Semin Diagn Pathol 2016 Dec 14. Epub 2016 Dec 14.
    Section of Dermatopathology, Division of Surgical & Cytological Pathology, University of Virginia Medical Center, Charlottesville, VA, USA. Electronic address:
    Granulomas of the skin may be classified in several ways. They are either infectious or non-infectious in character, and they contain areas of necrobiosis or necrosis, or not. Responsible infectious agents may be mycobacterial, fungal, treponemal, or parasitic organisms, and each case of granulomatous dermatitis should be assessed histochemically for those microbes. Read More

    [Two children with intermediate uveitis and granuloma annulare from the same neighbourhood].
    Ophthalmologe 2017 Jan 9. Epub 2017 Jan 9.
    Universitäts-Augenklinik Tübingen, Eberhard Karls Universität Tübingen, Elfriede-Aulhorn-Straße 7, 72076, Tübingen, Deutschland.
    Two children from the same neighbourhood presented with concomitant granuloma annulare (GA) and intermediate uveitis (IU) at an interval of 2 weeks. A coincidence seemed unlikely, as IU is very rare in children and even more so in connection with GA. Thorough diagnosis was performed to exclude other associated diseases. Read More

    Palisaded Granuloma on the Nose: An Atypical Presentation of Granuloma Annulare.
    Am J Dermatopathol 2017 Feb;39(2):e26-e28
    *Department of Dermatology, School of Medicine, University of Puerto Rico, San Juan, PR; and †Department of Dermatology, University of Puerto Rico, San Juan, PR.
    Granuloma annulare (GA) is a common, asymptomatic dermatosis of unknown etiology. Many variants exist, among them widespread papules, papules in photodistribution, papules marked by tiny crusts ("perforating" GA), patches, plaques, and nodules (subcutaneous GA). The histopathological hallmark is a palisaded histiocytic infiltrate surrounding a central area of degenerated collagen with abundant mucin deposits. Read More

    Specific skin signs as a cutaneous marker of diabetes mellitus and the prediabetic state - a systematic review.
    Dan Med J 2017 Jan;64(1)
    Introduction: Diabetes mellitus and the prediabetic state are associated with a number of skin manifestations. This study is a systematic review of the following manifestations: acanthosis nigricans (AN), skin tags (ST), diabetic dermopathy (DD), rubeosis faciei (RF), pruritus (PR), granuloma annulare (GA), necrobiosis lipoidica (NL), scleroedema diabeticorum (SD) and bullosis diabeticorum (BD). These conditions possibly relate to underlying diabetogenic mechanisms. Read More

    Subcutaneous dirofilariasis: a masquerade of a palisaded granulomatous dermatitis.
    J Cutan Pathol 2017 Apr 15;44(4):373-375. Epub 2017 Feb 15.
    Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
    Dirofilaria species are roundworms responsible for "heartworm" in canines. On occasion, humans are an accidental host, resulting in pulmonary (Dirofilaria immitis) or extrapulmonary (Dirofilaria repens) manifestations. Of the extrapulmonary sites of involvement, subcutaneous involvement is particularly common. Read More

    O'Brien's Granuloma- A Case Report.
    J Clin Diagn Res 2016 Oct 1;10(10):WD05-WD06. Epub 2016 Oct 1.
    Resident, Department of Dermatology, Kasturba Medical College , Mangaluru, Karnataka, India .
    Actinic granuloma is a self-limiting chronic disorder with elastolytic granulomas, mainly of the sun exposed skin and unknown pathogenesis. We report a case of a middle aged woman with multiple annular erythematous lesions. Histopathology revealed degenerated elastic fibres with histiocyte aggregates surrounded by multiple giant cells suggestive of elastolytic granulomas. Read More

    Acute myelogenous leukemia presenting with uveitis, optic disc edema, and granuloma annulare: Case report.
    Can J Ophthalmol 2016 Oct 19;51(5):e153-e155. Epub 2016 Jul 19.
    Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX; Baylor College of Medicine, Houston, TX; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, New York, NY; Department of Ophthalmology, The University of Texas Medical Branch, Galveston, TX; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA; UT MD Anderson Cancer Center. Electronic address:

    Dermoscopy could be useful in differentiating sarcoidosis from necrobiotic granulomas even after treatment with systemic steroids.
    Dermatol Pract Concept 2016 Jul 31;6(3):17-22. Epub 2016 Jul 31.
    Dermatology Department Cairo University, Cairo, Egypt.
    Background: Diagnosing cutaneous sarcoidosis and necrobiotic granulomas is challenging.

    Objective: Assessing the value of dermoscopy in differentiating cutaneous sarcoidosis from necrobiotic granulomas and evaluating whether their dermoscopic features will be altered after treatment.

    Methods: Nineteen cutaneous sarcoidosis and 11 necrobiotic granuloma patients (2 necrobiosis lipoidica, 4 granuloma annulare and 5 rheumatoid nodule) were included in this study. Read More

    Pressure-induced localised granuloma annulare following use of an elbow splint.
    Prosthet Orthot Int 2016 Sep 9. Epub 2016 Sep 9.
    Specialist Connect, Brisbane, QLD, Australia.
    Background: Granuloma annulare is a benign, inflammatory skin disorder with no distinct aetiology or widely accepted pathogenic process.

    Case Description And Methods: We report a case of a 71-year old female with a 4-year history of an erythematous annulopapular lesion to the lateral aspect of her right forearm from a pressure pleat ridge in a high-density polyethylene plastic elbow orthosis to immobilise a prior radial head fracture. Morphological and histopathological assessment was consistent for granuloma annulare. Read More

    Granuloma annulare: Pathogenesis, disease associations and triggers, and therapeutic options.
    J Am Acad Dermatol 2016 Sep;75(3):467-79
    Department of Dermatology, Perelman School of Medicine at the Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:
    Granuloma annulare (GA) represents a cutaneous reaction pattern of unknown cause with a variety of previously described potential disease associations and triggers. This review attempts to synthesize the available data regarding potential etiopathogenesis, reviews the available data on potential GA disease associations and work-up indicated for patients with GA, and discusses potential inciting triggers. In the final part, this article describes the available treatments options and supporting data, and provides a framework for approaching management of patients with GA. Read More

    Granuloma annulare: Clinical and histologic variants, epidemiology, and genetics.
    J Am Acad Dermatol 2016 Sep;75(3):457-65
    Department of Dermatology, Perelman School of Medicine at the Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:
    Granuloma annulare (GA) is a poorly understood condition characterized by a set of clinical morphologic variants with 2 predominant histopathologic patterns of inflammation. This review provides a comprehensive overview of the available information about the clinical variants and histopathologic features, current epidemiologic data, and potential genetic underpinnings of GA. Much of the current understanding of GA is based on retrospective studies, case series, and case reports; this review aims to synthesize the available information and present it clearly for practicing dermatologists. Read More

    Penile Granuloma Annulare.
    Skinmed 2016 1;14(3):233-6. Epub 2016 Jun 1.
    Department of Dermatology, Sir Paul Boffa Hospital, Malta.
    A 50-year-old man presented to the genitourinary medicine clinic with a 3-year history of skin-colored circular papules over the shaft and glans of the penis. There were multiple lesions that were initially small, around 0.3 cm in diameter, and gradually enlarged. Read More

    Paradoxical reactions under TNF-α blocking agents and other biological agents given for chronic immune-mediated diseases: an analytical and comprehensive overview.
    RMD Open 2016 15;2(2):e000239. Epub 2016 Jul 15.
    Department of Dermatology, University Hospital of Besançon, Besançon, France; University of Franche-Comté, Besançon, France.
    Paradoxical adverse events (PAEs) have been reported during biological treatment for chronic immune-mediated diseases. PAEs are defined as the occurrence during biological agent therapy of a pathological condition that usually responds to this class of drug. A wide range of PAEs have been reported including dermatological, intestinal and ophthalmic conditions, mainly with antitumour necrosis factor α (TNF-α) agents. Read More

    Interstitial granulomatous dermatitis demonstrating small, discrete skin-colored papules.
    J Biol Regul Homeost Agents 2016 Apr-Jun;30(2 Suppl 2):49-52
    Department of Dermatology, Wakayama Medical University, Wakayama, Japan.
    We report the case of a 67-year-old female with a rare variant of interstitial granulomatous dermatitis showing multiple skin-colored papules. Clinically, numerous skin-colored or reddish papules were distributed on her back and posterior thighs with itchy scaly erythema on the upper back. After topical steroid application, skin-colored papules still remained after the disappearance of itchy scaly erythema. Read More

    Generalized annular granuloma associated with crowned dens syndrome, which resolved with colchicine treatment.
    Clin Exp Dermatol 2016 Aug 23;41(6):640-2. Epub 2016 Jun 23.
    IRCCS, AOU. San Martino-IST, Di.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy.
    Granuloma annulare (GA) is a chronic, benign, and usually self-limiting cutaneous inflammatory disease, typically characterized by small, localized, skin-coloured papules that are usually asymptomatic or mildly pruriginous. Its aetiopathogenesis is still unknown and treatments are rarely effective. Generally, 50-70% of localized GA cases are self-limiting and show spontaneous resolution after 1-2 years, whereas disseminated GA is less likely to disappear without treatment. Read More

    Interstitial Mycosis Fungoides: A Clinicopathologic Study of 21 Patients.
    Am J Surg Pathol 2016 Oct;40(10):1360-7
    *Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria †Department of Dermatology, University of Modena and Reggio Emilia, Modena ‡Department of Dermatology, Galliera Hospital, Genoa §Division of Dermatology, San Gallicano Dermatological Institute, Rome, Italy.
    Interstitial mycosis fungoides (IMF) is a rare histopathologic variant of mycosis fungoides (MF) that may mimic other inflammatory dermatoses, mainly interstitial granuloma annulare, inflammatory morphea, and interstitial granulomatous dermatitis. Only small series and sporadic case reports of IMF have been described in the literature. We reviewed 27 specimens from 21 patients with IMF (M:F=11:10, median age 60) to better characterize clinical, histopathologic, and immunohistochemical features of this disease. Read More

    Ultraviolet A1 phototherapy: One center's experience.
    Indian J Dermatol Venereol Leprol 2017 Jan-Feb;83(1):60-65
    Department of Dermatology and Photobiology, Ninewells University Hospital, Dundee, DD1 9SY, Scotland, UK.
    Background: Ultraviolet A1(UVA1) phototherapy is increasingly being used in the treatment of morphea, atopic dermatitis, lupus and some other recalcitrant dermatoses. We present a retrospective review of our experience with this modality.

    Aim: To evaluate the treatment response rates for various dermatoses and adverse effects of UVA1 phototherapy. Read More

    Intraorbital granuloma annulare in an elderly patient.
    Orbit 2016 Jun 10;35(3):170-2. Epub 2016 May 10.
    a Department of Ophthalmology , Edward S. Harkness Eye Institute, Columbia University , New York , New York , USA.
    Classically, granuloma annulare (GA) is a cutaneous disorder localized to the dorsum of the hands and/or feet in children and young adults. Very rarely it can present on the face and rarer still on periorbital structures such as the eyelid and orbital rim. Diagnosis hinges on clinical presentation and histological features, such as palisading granulomas with central destruction of collagen, presence of mucin and lymphohistiocytic infiltration. Read More

    Folliculocentric Herpes: A Clinicopathological Study of 28 Patients.
    Am J Dermatopathol 2017 Feb;39(2):89-94
    *Regional Medical Laboratories, St. John Medical Center, Tulsa, OK; †Department of Pathology, Weill Cornell Medicine, New York, NY; and ‡Division of Dermatopathology, Department of Pathology, Weill Cornell Medicine, New York, NY.
    Background: The cutaneous manifestations of herpes infection are primarily in the context of active infection and of the post-herpetic zosteriform eruption. The former manifests cytopathic alterations diagnostic of herpes. The latter includes lichen planus-like and granuloma annulare-like eruptions and lymphocytoma cutis. Read More

    Histopathologic characteristics of scleromyxedema: A study of a series of 34 cases.
    J Am Acad Dermatol 2016 Jun 18;74(6):1194-200. Epub 2016 Feb 18.
    Department of Dermatology, Ed. Herriot Hospital Group, Lyon, France.
    Background: Few histologic studies describe the histopathologic aspects of scleromyxedema.

    Objective: We sought to describe the histopathologic and immunohistochemical features of scleromyxedema in a large series of patients.

    Methods: We studied all the cases with scleromyxedema diagnosed between 2000 and 2014 at participating centers. Read More

    Clinico-Pathological Study of Cutaneous Granulomatous Lesions- a 5 yr Experience in a Tertiary Care Hospital in India.
    Iran J Pathol 2016 ;11(1):54-60
    Dept. of Pathology, Calcutta National Medical College, Kolkata. India.
    Background: Granulomatous dermatoses are common skin pathology, often need histopathological confirmation for diagnosis. Histologically six sub-types of granulomas found in granulomatous skin diseases- tuberculoid, sarcoidal, necrobiotic, suppurative, foreign body & histoid type. The aims of the present study were clinico-pathological evaluation of granulomatous skin lesions and their etiological classification based on histopathological examination. Read More

    Subcutaneous Granuloma Annulare: A Diagnostic Conundrum-Learning From Mistakes.
    Pediatr Emerg Care 2016 Jan 16. Epub 2016 Jan 16.
    From the *Pediatric Surgery and †Department of Pediatrics, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Trieste, Italy.
    Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary. Read More

    Expanding the clinicopathological spectrum of late cutaneous Lyme borreliosis (acrodermatitis chronica atrophicans [ACA]): A prospective study of 20 culture- and/or polymerase chain reaction (PCR)-documented cases.
    J Am Acad Dermatol 2016 Apr 9;74(4):685-92. Epub 2016 Jan 9.
    Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France. Electronic address:
    Background: The diagnosis of acrodermatitis chronica atrophicans (ACA), the late cutaneous manifestation of Lyme borreliosis, can be challenging. Histologic changes in ACA have been described in a few studies from endemic countries, relying on cases documented by serology only.

    Objectives: We sought to reassess the clinicopathological spectrum of ACA in a series of thoroughly documented cases. Read More

    Multiple Granuloma Annulare in a 2-year-old Child.
    Indian J Dermatol 2015 Nov-Dec;60(6):636
    Department of Dermatology, Venereology and Leprosy, Navodaya Medical College Hospital and Research Centre, Raichur, India.
    Granuloma annulare is a benign, self-limiting, inflammatory and granulomatous disease of unknown etiology occurring in both adults and children. An 18-month-old male child had multiple progressive annular plaques over the lower extremities. Clinical and histopathological features were consistent with granuloma annulare. Read More

    [Non-infectious granulomatous inflammation: Focus on the lungs and skin].
    Pathologe 2016 Mar;37(2):172-82
    Dermatopathologie Lübeck, Lübeck, Deutschland.
    Whereas a granulomatous reaction represents a physiologically useful immune defense mechanism against many infections, in autoimmune diseases granuloma formation and the concomitant inflammatory mechanisms may provoke a potentially organ-threatening reaction. Morphologically, several defined sub-types of granuloma have long been known, e.g. Read More

    Lichen sclerosus and granuloma annulare of the foreskin: a significant association.
    Rom J Morphol Embryol 2015 ;56(3):1179-83
    Department of Anatomical Pathology, University of Cantabria and IDIVAL, Santander, Spain;
    Lichen sclerosus (LS) is considered to be a disease resulting of local immune dysregulation. A delayed-type hypersensitivity reaction and cell-mediated immune response are hypothesized to be the pathogenesis of granuloma annulare (GA). The case is presented of an uncircumcised 45-year-old man who developed lesions of LS and GA in his foreskin. Read More

    Interstitial Mycosis Fungoides With Lichen Sclerosus-Like Clinical and Histopathological Features.
    Am J Dermatopathol 2016 Feb;38(2):138-43
    *Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey; †Kempf und Pfaltz, Histologische Diagnostik, Zürich, Switzerland; and ‡Department of Pathology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
    Mycosis fungoides (MF) simulates a variety of dermatologic disorders histopathologically and clinically, well deserving the designation of a great mimicker. Interstitial MF is a rare, but well-recognized histopathological variant resembling the interstitial form of granuloma annulare or the inflammatory phase of morphea. From a clinical standpoint, MF can have a wide array of manifestations, including an anecdotal presentation with lesions clinically suggestive of lichen sclerosus (LS). Read More

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