Generalized granuloma annulare explained

Generalized granuloma annulare is a skin condition of unknown cause, tending to affect women in the fifth and sixth decades, presenting as a diffuse but symmetrical, papular or annular eruption of more than ten skin lesions, and often hundreds.^[1]

Signs and symptoms

Generalized granuloma annulare is a chronic granulomatous dermatosis that typically affects young adults' distal extremities and manifests as annular grouped papules.^[2] On the trunk and extremities, numerous flesh-colored papules arranged in an annular pattern are the hallmark of generalized granuloma annulare. These lesions are frequently itchy, in contrast to the traditional presentation.^[3]

Causes

A variety of factors, such as infection, sun exposure, medication use, and trauma, appear to play a role in the development of the disease.^[4]

Diagnosis

It has been observed that certain laboratory abnormalities exist, such as hyperlipidemia, hypergammaglobulinemia, and the presence of circulating antinuclear antibodies.^[5] Histopathologic analysis may show lymphohistiocytic granuloma-related alterations primarily in the papillary and mid dermis. Palisaded or interstitial patterns, or a combination of the two, may be seen in inflammatory infiltrates.^[4]

Treatment

Generalized granuloma annulare is mostly treated with phototherapy as opposed to oral steroids, however treatment efficacy is constrained by a high rate of recurrence after stopping treatment.^[6]

Epidemiology

Generalized granuloma annulare accounts for up to 15% of granuloma annulare cases.^[3]

See also

• Granuloma annulare
• List of cutaneous conditions
• List of human leukocyte antigen alleles associated with cutaneous conditions

Further reading

• Saber . Mina . Khalili Tembi . Roghaye Sadat . Asilian . Ali . Generalized granuloma annulare in a case of breast cancer: A case report and review of the literature . Clinical Case Reports . 9 . 10 . 2021 . e04980 . 2050-0904 . 34703610 . 8521271 . 10.1002/ccr3.4980 . none.
• Polineni . Sai P. . Lawyer . Steven . Generalized granuloma annulare associated with essential thrombocythemia . Clinical Case Reports . 8 . 6 . 2020 . 2050-0904 . 32577266 . 7303850 . 10.1002/ccr3.2812 . 1065–1068 . none.

External links

• VisualDx

Notes and References

1. Book: James, William D. . Berger, Timothy G. . Andrews' Diseases of the Skin: clinical Dermatology . Saunders Elsevier . 2006 . 978-0-7216-2921-6 . etal.
2. Mangold . Aaron R. . Cumsky . Helen J.L. . Costello . Collin M. . Xie . Daniel Y. . Buras . Matthew R. . Nelson . Steven A. . DiCaudo . David J. . Sekulic . Aleksandar . Pittelkow . Mark R. . Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies: A case–control study . Journal of the American Academy of Dermatology . Elsevier BV . 79 . 5 . 2018 . 0190-9622 . 10.1016/j.jaad.2018.06.022 . 913–920.e1. 29920319 . 49309849 .
3. Web site: Schmieder . Shawn J. . Harper . Chelsea D. . Schmieder . George J. . Granuloma Annulare . StatPearls Publishing . June 21, 2023 . 29083715 . February 5, 2024.
4. Lee . Jun Hyo . Cho . Soyun . Resolution of refractory generalized granuloma annulare after treatment with alitretinoin . JAAD Case Reports . Elsevier BV . 24 . 2022 . 2352-5126 . 10.1016/j.jdcr.2022.04.006 . 38–41. 35600571 . 9118481 .
5. Dabski . Krzysztof . Winkelmann . R.K. . Generalized granuloma annulare: Clinical and laboratory findings in 100 patients . Journal of the American Academy of Dermatology . Elsevier BV . 20 . 1 . 1989 . 0190-9622 . 10.1016/s0190-9622(89)70005-0 . 39–47.
6. Lukács . J. . Schliemann . S. . Elsner . P. . Treatment of generalized granuloma annulare – a systematic review . Journal of the European Academy of Dermatology and Venereology . Wiley . 29 . 8 . February 4, 2015 . 0926-9959 . 10.1111/jdv.12976 . 1467–1480. 25651003 . 20884856 .