Granuloma annulare
| Granuloma annulare | |
|---|---|
| Classification and external resources | |
 Granuloma annulare on hand |
|
| ICD-10 | L92.0 |
| ICD-9 | 695.89 |
| DiseasesDB | 5414 |
| eMedicine | derm/169 |
| MeSH | D016460 |
Granuloma annulare is a chronic skin disease consisting of a rash with reddish bumps arranged in a circle or ring. Granuloma annulare is different from warts, and cryotherapy treatment will not work. It most often affects children, young and older adults and it is slightly more common in females (60/40 ratio).
Contents |
[edit] Types
Granuloma annulare may be divided into the following types:[1]:703-5
[edit] Causes
The condition is usually seen in otherwise healthy people. Occasionally, it may be associated with diabetes or thyroid disease. It has also been associated with auto-immune diseases like SLE.
Its cause is unknown.[2]
[edit] Presentation
Aside from the visible rash, granuloma annulare is usually asymptomatic. Sometimes the rash may burn or itch. Patients usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands or feet, often centered around joints or knuckles. The bumps are caused by the clustering of T cells below the skin. Occasionally, multiple rings may be found. Rarely, granuloma annulare may appear as a firm nodule under the skin of the arms or legs.
[edit] Pathology
Granuloma annulare, microscopically, consists of dermal epithelioid histiocytes around a central zone of mucin - a so-called palisaded granuloma. The main histomorphologic differential diagnosis in necrobiosis lipoidica/necrobiosis lipoidica diabeticorum, which typically has plasma cells.
[edit] Prognosis and treatment
Because granuloma annulare is usually asymptomatic, treatment may not be necessary except for cosmetic reasons.[3] Most lesions of granuloma annulare disappear in pre-pubertal patients with no treatment within two years while older patients (50+) have rings for upwards of 20 years. The appearance of new rings years later is not uncommon. In some cases, successful treatment has involved topical and oral corticosteroids such as clobetasol propionate or methylprednisolone. Subdermally injected corticosteroids such as triamcinolone have also been effective in reducing the size and spread of granuloma annulare.[4]
[edit] History
The disease was first described in 1895 by Thomas Colcott Fox and it was named granuloma annulare by Henry Radcliffe Crocker in 1902.[5]
[edit] See also
[edit] References
- ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
- ^ "Granuloma annulare: Causes - MayoClinic.com". http://www.mayoclinic.com/health/granuloma-annulare/DS00793/DSECTION=causes.
- ^ "Diagnosis and Management of Granuloma Annulare - November 15, 2006 -- American Family Physician". http://www.aafp.org/afp/20061115/1729.html.
- ^ "Granuloma Annulare: Treatment & Medication - March 14, 2007". http://emedicine.medscape.com/article/1123031-treatment.
- ^ Shanmuga1, Sekar C.; Rai1, Reena; Laila1, A.; Shanthakumari, S.; Sandhya, V. (2010), "Generalized granuloma annulare with tuberculoid granulomas: A rare histopathological variant", Indian Journal of Dermatology, Venereology and Leprology 76 (1): 73–75, doi:10.4103/0378-6323.58691, http://www.ijdvl.com/article.asp?issn=0378-6323;year=2010;volume=76;issue=1;spage=73;epage=75;aulast=Shanmuga, retrieved 23 May 2010
[edit] External links
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