[Generalized granuloma annulare: A clinicopathological study].
Granulome annulaire généralisé : étude anatomoclinique.
Adolescent
Adrenal Cortex Hormones
/ therapeutic use
Adult
Aged
Aged, 80 and over
Antimalarials
/ therapeutic use
Autoimmune Diseases
/ epidemiology
Child
Child, Preschool
Comorbidity
Diabetes Mellitus
/ epidemiology
Doxycycline
/ therapeutic use
Dyslipidemias
/ epidemiology
Female
France
/ epidemiology
Granuloma Annulare
/ drug therapy
Humans
Hypersensitivity, Immediate
/ epidemiology
Immunosuppression Therapy
/ adverse effects
Male
Middle Aged
Neoplasms
/ epidemiology
Phototherapy
Retrospective Studies
Young Adult
Clinicopathological study
Generalized granuloma annulare
Granulome annulaire généralisé
Étude anatomoclinique
Journal
Annales de dermatologie et de venereologie
ISSN: 0151-9638
Titre abrégé: Ann Dermatol Venereol
Pays: France
ID NLM: 7702013
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
13
10
2018
revised:
13
02
2019
accepted:
06
09
2019
pubmed:
17
3
2020
medline:
31
12
2020
entrez:
16
3
2020
Statut:
ppublish
Résumé
Granuloma annulare (GA) is a benign granulomatous skin disorder that is generalized (GGA) in 15 % of cases. Although many case reports describe a relationship between GGA and systemic diseases, few large series have been published, and their association is debated. We present herein a series of GGA in order to describe their clinical and histological features. We included all biopsy-proven cases of GA presenting at the dermatopathology laboratory of Strasbourg where generalized (i.e. over 10 lesions). Clinical features were obtained from patients' medical files. We included 35 GGA, with a sex ratio of 0.5. The mean age was 54 years. Lesions were annular or non-annular in equal measure and were symptomatic in 25 % of cases. Most patients (77 %) had an associated disease, already known in 60 % of cases, including dyslipidemia (27 %), diabetes mellitus (20 %), immunosuppressive drugs (17 %), atopy (17 %), auto-immune disease (17 %), hematological disease (14 %), and cancer (9 %). Histological analysis revealed the predominant pattern to be interstitial (54 %) rather than palisading (20 %), having no correlation with clinical type. Eosinophils were frequent (46 %) in GA but were not correlated with systemic disease or drug taking. Among the 40 % of patients treated, 50 % had a successful outcome on topical corticosteroids, doxycycline, antimalarial drugs or phototherapy. GGA differs from localized GA, which is mostly associated with an already known systemic disease, whether metabolic, infectious or neoplastic, uncorrelated with clinical or histological features, and screening is necessary.
Sections du résumé
BACKGROUND
BACKGROUND
Granuloma annulare (GA) is a benign granulomatous skin disorder that is generalized (GGA) in 15 % of cases. Although many case reports describe a relationship between GGA and systemic diseases, few large series have been published, and their association is debated. We present herein a series of GGA in order to describe their clinical and histological features.
PATIENTS AND METHODS
METHODS
We included all biopsy-proven cases of GA presenting at the dermatopathology laboratory of Strasbourg where generalized (i.e. over 10 lesions). Clinical features were obtained from patients' medical files.
RESULTS
RESULTS
We included 35 GGA, with a sex ratio of 0.5. The mean age was 54 years. Lesions were annular or non-annular in equal measure and were symptomatic in 25 % of cases. Most patients (77 %) had an associated disease, already known in 60 % of cases, including dyslipidemia (27 %), diabetes mellitus (20 %), immunosuppressive drugs (17 %), atopy (17 %), auto-immune disease (17 %), hematological disease (14 %), and cancer (9 %). Histological analysis revealed the predominant pattern to be interstitial (54 %) rather than palisading (20 %), having no correlation with clinical type. Eosinophils were frequent (46 %) in GA but were not correlated with systemic disease or drug taking. Among the 40 % of patients treated, 50 % had a successful outcome on topical corticosteroids, doxycycline, antimalarial drugs or phototherapy.
DISCUSSION
CONCLUSIONS
GGA differs from localized GA, which is mostly associated with an already known systemic disease, whether metabolic, infectious or neoplastic, uncorrelated with clinical or histological features, and screening is necessary.
Identifiants
pubmed: 32171551
pii: S0151-9638(20)30063-6
doi: 10.1016/j.annder.2019.09.617
pii:
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Antimalarials
0
Doxycycline
N12000U13O
Types de publication
Journal Article
Langues
fre
Sous-ensembles de citation
IM
Pagination
271-278Informations de copyright
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