Acta Dermatovenerol Croat 2017 Jul;25(2):167-169

Professor Joanna Maj, MD, PhD, Department and Clinic of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chałubińskiego 1, PL-50-368 Wrocław, Poland;

Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Read More

Acta Dermatovenerol Croat 2017 Jul;25(2):164-166

Efstathia Pasmatzi, MD, Department of Dermatology School of Medicine University of Patras, 26504 Rio-Patras, Greece;

Dear Editor, Molluscum contagiosum (MC) is a very common skin infection caused by a molluscipox virus gene of the poxvirus family. It usually occurs in young children, sexually active adults, and immunocompromised individuals. The typical clinical picture of this infection is characterized by asymptomatic flesh-colored, single or multiple papules, measuring 2-6 mm in diameter with a central umbilication that occur on the skin and the mucous membranes. Read More

Case Rep Dermatol 2017 May-Aug;9(2):60-64. Epub 2017 Jul 13.

Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.

Scabies is a relatively common parasitic infection, which has sometimes been associated with the formation of granuloma annulare. We report the case of an 86-year-old female who developed a non-necrotizing granulomatous dermatitis after a scabies infestation. This case highlights the importance of considering scabies in the differential diagnosis when granulomatous dermatitis is noted histologically that cannot be explained by other causes. Read More

Mod Rheumatol 2017 Aug 24:1-15. Epub 2017 Aug 24.

a Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit , University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino , Genova , Italy.

TNF-α inhibitors have demonstrated efficacy both as monotherapy and in combination with disease-modifying anti-rheumatic drugs (DMARDs) in the treatment of chronic inflammatory immune-mediated diseases such as rheumatoid arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis (AS), psoriasis (Ps) and/or psoriatic arthritis (PsA) and may be administered off-label to treat disseminated granuloma annulare, systemic lupus erythematosus and systemic sclerosis. There are several TNF-α inhibitors available for clinical use including infliximab, adalimumab, golimumab, certolizumab pegol and etanercept. In this article, we discuss the efficacy and safety of etanercept in the treatment of spondyloarthritis and juvenile idiopathic arthritis (JIA). Read More

Pan Afr Med J 2017 10;27:26. Epub 2017 May 10.

Service de Dermatologie-vénéréologie, Centre Hospitalier Universitaire Avicenne, Rabat, Maroc.

Actas Dermosifiliogr 2017 Jul 13. Epub 2017 Jul 13.

Servicio de Dermatología, Hospital Universitario Araba, Vitoria-Gasteiz, España.

Australas J Dermatol 2017 Aug 3;58(3):e155-e156. Epub 2017 Jul 3.

Cutaneous Leishmaniasis Research Center, Department of Dermatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Ann Dermatol Venereol 2017 Jun 27. Epub 2017 Jun 27.

Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.

Background: Annular elastolytic giant cell granuloma (AEGCG), a rare entity first described in 1979, is very similar to O'Brien actinic granuloma (AG), first described in 1975. Since then, many cases have been published under one or other of the two names. We performed a single-centre histopathology study to identify the distinguishing features and determine whether there was any objective difference between AEGCG and AG. Read More

J Dermatol 2017 Jun 21. Epub 2017 Jun 21.

Department of Dermatology and Key lab of Immunodermatology, First Hospital of China Medical University, Shenyang, China.

Case Rep Dermatol Med 2017 22;2017:5918708. Epub 2017 May 22.

Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 5th Floor, New York, NY 10029, USA.

Granuloma annulare (GA) is a benign inflammatory dermatosis characterized clinically by dermal papules and annular plaques. The pathogenesis of GA is not well understood, although it is thought to result from a delayed-type hypersensitivity reaction in which inflammatory cells elicit connective tissue degradation. This condition has been seen following the use of several drugs, including tumor necrosis factor-alpha (TNF-α) inhibitors, which paradoxically have also been reported to treat GA. Read More

Hautarzt 2017 Jul;68(7):553-559

Konsultations- und Referenzzentrum für Vaskulitis-Diagnostik, MVZ am Marienkrankenhaus gGmbH, Hamburg, Deutschland.

A particular diagnostic situation in the classification of a granulomatous dermatitis results when no circumscribed granulomas but instead a diffuse interstitial histiocytic inflammatory infiltrate, a granulomatous vasculitis or a neoplastic lymphocytic infiltrate is found. Interstitial granulomatous dermatitis was originally described in patients with arthritis. Later, it was recognized that there are also associations with other usually immunological diseases. Read More

Indian Dermatol Online J 2017 May-Jun;8(3):218-220

Department of Dermatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

Hautarzt 2017 Jul;68(7):536-541

Hautklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.

The palisading granulomatous dermatitides comprise a group of different skin diseases with similar histomorphologic forms of granuloma in the skin. Histopathologically characteristic are areas in the reticular dermis and subcutaneous fat with degenerated bundles of collagen surrounded by histiocytes and multinucleate giant cells aligned in a palisade (necrobiotic granuloma). Within the center of palisaded granulomas, mucin or fibrin can be found. Read More

Clin Cosmet Investig Dermatol 2017 26;10:141-145. Epub 2017 Apr 26.

Department of Dermatology, Psoriasis Research Center, Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Granuloma annulare is a benign inflammatory disease of the skin. The etiology and pathogenesis of the disease are not yet determined, but some authors have proposed that it might be associated with a variety of underlying conditions such as thyroid disorders, diabetes mellitus and positive tuberculin skin test.

Objective: This study was conducted to find the probable relationship between granuloma annulare and diabetes mellitus, thyroid disorders and positive tuberculin skin test. Read More

Ann Dermatol Venereol 2017 Apr 21. Epub 2017 Apr 21.

Service de dermatologie, centre hospitalier régional universitaire, 191, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.

Background: Deep granuloma annulare is a fairly rare variety of granuloma annulare. It is seen predominantly in children and mainly affects the anterior aspect of the legs and the top of the feet; cephalic presentation is rare. Below, we report three cases of deep granuloma annulare in children presenting solely at the cephalic extremity. Read More

Pediatr Dermatol 2017 Jul 17;34(4):e207-e208. 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

Am J Clin Dermatol 2017 Aug;18(4):541-553

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

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

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

J Am Acad Dermatol 2017 04;76(4):765-767

Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:

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

Am J Dermatopathol 2017 Aug;39(8):625-627

*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

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

G Ital Dermatol Venereol 2017 Apr;152(2):193-195

Section of Dermatology, Academic Department of Systems Medicine, School of Medicine, Tor Vergata University Hospital, Rome, Italy.

Dermatology 2017 19;233(1):74-79. 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

Cutan Ocul Toxicol 2017 Sep 17;36(3):300-301. 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

Semin Diagn Pathol 2017 May 14;34(3):301-311. 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

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

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

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

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

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

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:

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

JAAD Case Rep 2016 Jul 27;2(4):357-9. Epub 2016 Aug 27.

Dermpath Diagnostics New England, Marlborough, Massachusetts.

Prosthet Orthot Int 2017 Jun 9;41(3):311-313. 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

N Engl J Med 2016 Sep;375(10):e21

Peking University First Hospital, Beijing, China

An Bras Dermatol 2016 Jul-Aug;91(4):552-3

Department of Dermatology. Okmeydani Training and Research Hospital - Istanbul, Turkey.

J Am Acad Dermatol 2016 Sep;75(3):467-479

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

J Am Acad Dermatol 2016 Sep;75(3):457-465

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

Cutis 2016 Jul;98(1):E10-1

Department of Dermatology, University of Massachusetts Medical Center, Worcester, USA.

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

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

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

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

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

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

Eur J Dermatol 2016 Aug;26(4):410-2

Department of Dermatology, National Hospital Organization Kyushu Medical Center.

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

J Dermatol 2016 Dec 6;43(12):1443-1444. Epub 2016 May 6.

Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.