1
|
Margerin F, Cribier B. Granulome annulaire élastolytique à cellules géantes : étude anatomoclinique. Ann Dermatol Venereol 2017; 144:589-598. [DOI: 10.1016/j.annder.2017.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 01/13/2017] [Accepted: 03/03/2017] [Indexed: 10/19/2022]
|
2
|
Gutiérrez-González E, Pereiro M, Toribio J. Elastolytic Actinic Giant Cell Granuloma. Dermatol Clin 2015; 33:331-41. [DOI: 10.1016/j.det.2015.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
3
|
Shoimer I, Wismer J. Annular Elastolytic Giant Cell Granuloma Associated with Temporal Arteritis Leading to Blindness. J Cutan Med Surg 2011; 15:293-7. [DOI: 10.2310/7750.2011.10042] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous disorder characterized by giant cells in the dermis phagocytosing damaged elastin fragments. Objective: We report a case of a 71-year-old man presenting with erythematous plaques in predominantly sun-exposed areas. Method: A diagnosis of AEGCG was made based on the clinical and histologic picture, and treatment with systemic steroids was initiated. However, while tapering the steroid dose, the patient developed a radiating headache that progressed to temporal arteritis and eventual blindness in the right eye. Conclusion: There have been only two previous case reports presenting an association between AEGCG and temporal arteritis. This report explores AEGCG and its possible relationship to temporal arteritis along with possible treatment regimens cited in the current literature.
Collapse
Affiliation(s)
- Ilya Shoimer
- From the Department of Dermatology, McMaster University, Hamilton, ON
| | - Judy Wismer
- From the Department of Dermatology, McMaster University, Hamilton, ON
| |
Collapse
|
4
|
Djilali-Bouzina F, Grange F, Krzisch S, Schnebelen MP, Grosshans E, Guillaume JC. [Annular elastolytic giant cell granuloma]. Ann Dermatol Venereol 2010; 137:536-40. [PMID: 20804898 DOI: 10.1016/j.annder.2010.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 04/16/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Annular elastolytic giant cell granuloma (AEGCG) is a rare form of granulomatous dermatosis. It is characterised histologically by phagocytosis of elastic fibres by multinucleated cells. We report a favourable outcome in a case of AEGCG following PUVA therapy and treatment with synthetic antimalarials. PATIENTS AND METHODS A 67-year-old retired wine grower presented with highly pruritic annular lesions with raised borders on the shoulders and trunk that had been present for several months. Histological examination of a biopsy sample from the erythematous border was characteristic of AEGCG. Various topical treatments proved ineffective and systemic corticosteroids attenuated the patient's pruritus but had no effect on the skin lesions. PUVA therapy resulted in regression of lesions on the trunk, but the rash spread to the patient's arms and was covered with epidermal microcysts. PUVA therapy was discontinued and treatment with a synthetic antimalarial (hydroxychloroquine 400mg/d) was initiated, resulting in complete regression of the lesions. DISCUSSION AEGC was isolated in 1979 by Hanke et al. on the basis of five cases seen in females. This is a rare form of dermatosis with some 30 cases being reported in the English literature. The clinical aspect is fairly evocative, with erythematous papular lesions, either alone or in groups, with a raised border and a lighter centre tending towards atrophy. In most cases, the lesions are found predominantly in areas exposed to sunlight. The histological appearance is characteristic, with an image of giant cell elastophagic granuloma from which the name of the disease is taken. This appearance allows the disease to be differentiated from a number of other granulomatous diseases. The aetiology is unknown and treatment is empirical. Spontaneous cure can occur and consistent results have not been obtained with any treatments. In our case, PUVA was partly successful, and the synthetic antimalarials resulted in complete regression of residual lesions.
Collapse
|
5
|
REVENGA F, ROVIRA I, PIMENTEL J, ALEJO M. Annular elastolytic giant cell granuloma-actinic granuloma? Clin Exp Dermatol 2006. [DOI: 10.1111/j.1365-2230.1996.tb00013.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Lee HW, Lee MW, Choi JH, Moon KC, Koh JK. Annular elastolytic giant cell granuloma in an infant: Improvement after treatment with oral tranilast and topical pimecrolimus. J Am Acad Dermatol 2005; 53:S244-6. [PMID: 16227100 DOI: 10.1016/j.jaad.2005.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2004] [Revised: 02/03/2005] [Accepted: 02/03/2005] [Indexed: 10/25/2022]
Abstract
Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous skin disease of unknown origin that is characterized clinically by annular patches with erythematous borders and hypopigmented centers and histologically by loss of elastic fibers and elastophagocytosis. We report a case of AEGCG in an 8-month-old boy that was successfully treated with oral tranilast and topical pimecrolimus (Elidel 1.0% cream).
Collapse
Affiliation(s)
- Hae-Woong Lee
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | | | | | | | | |
Collapse
|
7
|
Pock L, Blazková J, Caloudová H, Varjassyová I, Konkolová R, Hercogová J. Annular elastolytic giant cell granuloma causes an irreversible disappearance of the elastic fibres. J Eur Acad Dermatol Venereol 2004; 18:365-8. [PMID: 15096158 DOI: 10.1111/j.1468-3083.2004.00912.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 67-year-old man presented with grouped red papules with a smooth surface coalescing to relatively well-demarcated plaques on his left thigh, in the axillae and on the lateral parts of the trunk. The plaques were growing slowly, and the older ones had a frilled surface. A skin biopsy showed a zone of disappearance of the elastic fibres with a rim of giant multinuclear cells with fragments of the elastic fibres in their cytoplasm. This finding is typical of annular elastolytic giant cell granuloma (AEGCG). After corticosteroid therapy, the inflammation resolved, causing the frilled surface of the lesions due to the disappearance of the elastic fibres. Remission of the skin lesions lasted for 1.5 years. A second skin biopsy taken from the site of the previous lesion showed the absence of the elastic fibres, thus their phagocytosis was irreversible.
Collapse
Affiliation(s)
- L Pock
- Dermatohistopathologic laboratory and Dermatovenereology clinic, 2nd Medical School of Charles University and University Hospital Motol, Mazurska 484, Prague 8, Czech Republic.
| | | | | | | | | | | |
Collapse
|
8
|
Limas C. The spectrum of primary cutaneous elastolytic granulomas and their distinction from granuloma annulare: a clinicopathological analysis. Histopathology 2004; 44:277-82. [PMID: 14987232 DOI: 10.1111/j.0309-0167.2004.01755.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Actinic granuloma (AG) and annular elastolytic giant cell granuloma (AEGCG) are terms commonly applied to cutaneous lesions characterized by elastolysis, elastophagocytosis and a multinucleated cell infiltrate. The aim of this study was to clarify the relationship of these lesions to granuloma annulare (GA) which they resemble clinically. METHODS AND RESULTS The clinicopathological data of 20 patients whose biopsies showed the histology of elastolytic granuloma as well as those of previously published cases with identical tissue changes were analysed to assess differences between AG, AEGCG and GA. The tissue changes of AG and AEGCG are identical and differ substantially from GA because of the predominant elastolysis and elastophagocytosis in the absence of necrobiosis and palisading granuloma. Actinic and/or thermal injury could be elicited frequently in the patient's history, but not always. CONCLUSIONS AG may be considered as an aetiopathological subdivision of AEGCG. Patients with biopsies showing both GA and AEGCG are occasionally encountered. AEGCG is easily differentiated from incidental elastolysis which may be seen in a variety of aetiologically unrelated processes.
Collapse
Affiliation(s)
- C Limas
- Department of Dermatopathology, Andreas Sygros Hospital, Athens, Greece
| |
Collapse
|
9
|
Doulaveri G, Tsagroni E, Giannadaki M, Bosemberg E, Limas C, Potouridou I, Zakopoulou N. Annular elastolytic giant cell granuloma in a 70-year-old woman. Int J Dermatol 2003; 42:290-1. [PMID: 12694495 DOI: 10.1046/j.1365-4362.2003.01767.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
10
|
Abstract
Mid-dermal elastolysis is an elastic tissue disorder of unknown causation. Various elastic tissue abnormalities have been described in granuloma annulare. To our knowledge, we report the first case illustrating the clinical and histologic colocalization of granuloma annulare and mid-dermal elastolysis.
Collapse
Affiliation(s)
- Brian B Adams
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0592, USA.
| | | |
Collapse
|
11
|
Biancone L, Geboes K, Spagnoli LG, Del Vecchio Blanco G, Monteleone I, Vavassori P, Palmieri G, Chimenti S, Pallone F. Metastatic Crohn's disease of the forehead. Inflamm Bowel Dis 2002; 8:101-5. [PMID: 11854608 DOI: 10.1097/00054725-200203000-00006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Metastatic Crohn's disease (CD) involves the presence of cutaneous granuloma distant from the intestinal lesions related to the disease, usually observed in colonic CD. CASE HISTORY A 35-year-old female with a permanent ileostomy following proctocolectomy for CD presented in 1999 with a 2-month history of an unusual skin lesion of the forehead. A diagnosis of CD of the ileum, colon, and rectum had been made in 1994. In 1997, a proctocolectomy with ileostomy was performed due to fistulizing severe refractory disease. Microscopic aspects of the intestinal lesions showed deep and fissuring ulcers. After surgery, she went into remission, and a small bowel follow-up in 1999 showed no recurrence, when she presented with the skin lesion of the forehead. MICROSCOPIC DATA: Histological analysis of endoscopical and surgical intestinal specimens showed chronic granulomatous inflammation of the ileum, colon, and rectum, confirming the diagnosis of CD. The forehead skin biopsy was examined by three independent histopathologists. The lesion was composed of numerous small granulomas (Ziehl-Nielsen negative), with no foreign bodies, mainly composed of CD68-positive and periodic acid Schiff-negative monocytes. Despite the low number of lymphocytes, the macroscopical and microscopical aspect of the forehead lesion, together with the clinical history, led to a diagnosis of rare metastatic CD of the forehead. CONCLUSIONS This case report describes the development of an unusual granulomatous skin lesion of the forehead in a patient with established CD showing no postoperative recurrence.
Collapse
Affiliation(s)
- Livia Biancone
- Department of Internal Medicine, Units of Gastroenterology and Dermatology, and Department of Pathology, University of Rome Tor Vergata, Via di Tor Vergata 135, 00133 Rome, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Ozkaya-Bayazit E, Büyükbabani N, Baykal C, Oztürk A, Okçu M, Soyer HP. Annular elastolytic giant cell granuloma: sparing of a burn scar and successful treatment with chloroquine. Br J Dermatol 1999; 140:525-30. [PMID: 10233280 DOI: 10.1046/j.1365-2133.1999.02723.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Annular elastolytic giant cell granuloma is a rare granulomatous skin disease characterized by phagocytosis of elastic fibres by multinucleated giant cells. Lesions are either solitary or grouped in a few annular patches with elevated borders and central atrophy. Sun-exposed areas are more commonly involved than covered skin. The pathogenesis of the disease is still controversial. We report a 72-year-old fair-skinned woman with unusual clinical findings. An irregularly shaped erythematous plaque covered the entire face, and hundreds of lichenoid papules were present on both sun-exposed and covered areas which gradually evolved into annular lesions of about 0.5-1 cm in diameter. Sparing of an old burn scar and a nearly complete lack of elastic fibres in the scar site were noted, illustrating the presumed importance of dermal elastic tissue in the pathogenesis. The course of the disease is chronic. Several treatments have been tried, with variable success. In our patient, improvement was achieved with chloroquine over a period of 16 weeks.
Collapse
Affiliation(s)
- E Ozkaya-Bayazit
- Department of Dermatology, Istanbul Medical Faculty, Istanbul University, Turkey.
| | | | | | | | | | | |
Collapse
|
13
|
Yen A, Tschen J, Raimer SS. Mid-dermal elastolysis in an adolescent subsequent to lesions resembling granuloma annulare. J Am Acad Dermatol 1997; 37:870-2. [PMID: 9366855 DOI: 10.1016/s0190-9622(97)80014-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
First described by Shelley and Wood in 1977, mid-dermal elastolysis (MDE) is a rare acquired disorder in which there is a bandlike absence of elastic tissue limited to the mid-dermis. In their patient, MDE developed in an area previously involved with recurrent episodes of urticaria. We describe a 15-year-old white girl with well-circumscribed, minimally palpable yellow-white plaques and wrinkling diagnosed histologically as MDE in areas clinically diagnosed 5 years previously as granuloma annulare. As in the first described patient, five years elapsed between clearance of the original skin lesions and the clinical appearance of MDE. To our knowledge, we report the first adolescent case of MDE localized to previous sites of lesions clinically consistent with granuloma annulare and propose that MDE represents an abnormal end-stage reaction to multiple processes.
Collapse
Affiliation(s)
- A Yen
- Department of Dermatology, University of Texas Medical Branch, Galveston 77555-0783, USA
| | | | | |
Collapse
|
14
|
Kurose N, Nakagawa H, Iozumi K, Nogita T, Furue M, Ishibashi Y. Systemic elastolytic granulomatosis with cutaneous, ocular, lymph nodal, and intestinal involvement. Spectrum of annular elastolytic giant cell granuloma and sarcoidosis. J Am Acad Dermatol 1992; 26:359-63. [PMID: 1569259 DOI: 10.1016/0190-9622(92)70056-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A 15-year-old Japanese girl had widespread annular serpiginous erythematous plaques, bilateral granulomatous uveitis, bloody diarrhea, and seronegative arthralgia. She also had anemia and leukopenia. The histopathologic findings were compatible with those of annular elastolytic giant cell granuloma. Elastolytic granulomas were also found in the cervical lymph nodes, terminal ileum, parietal peritoneum, and mesentery. Bilateral hilar lymphadenopathy, hypercalcemia, and an increased level of angiotensin converting enzyme were not observed throughout the clinical course. To the best of our knowledge, systemic elastolytic granulomatosis has not been previously described in annular elastolytic giant cell granuloma or sarcoidosis. This case may represent a type of granulomatosis in the broad spectrum of annular elastolytic giant cell granuloma and sarcoidosis.
Collapse
Affiliation(s)
- N Kurose
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Japan
| | | | | | | | | | | |
Collapse
|