Perforating granuloma annulare explained

Perforating granuloma annulare (PGA) is a skin condition of unknown cause, usually appearing on the dorsal hands, presenting as papules with a central keratotic core.^[1]

Signs and symptoms

Perforating granuloma annulare is characterized by flesh-to-red, umbilicated papules or pustules that range in size from 1 to 5 mm.^[2] These papules are frequently arranged in an annular form and frequently have an exudate, crusting, or scaling covering them.^[3] It is possible to characterize the distribution of PGA as either generalized or localized, since only 9% of patients initially present with a single lesion.^[4]

Causes

The cause of perforating granuloma annulare is unknown.^[3]

Diagnosis

Granulomas containing histiocytes arranged in a palisading pattern surround necrobiotic collagen, which is usually represented by the deposition of mucin and infrequently fibrin, according to the histopathologic features of PGA.^[3] Furthermore, the epidermis is perforated and necrobiotic material is expelled as a result of the granulomas' location in the superficial reticular dermis.^[4]

Treatment

Complete excision, psoralen and UVA therapy, intralesional triamcinolone, and high-dose corticosteroids are among the PGA treatment options.^[2]

See also

• Granuloma annulare
• Skin lesion

Further reading

• Lopez-Navarro . Norberto . Castillo . Rosa . Gallardo . MarÍa A. . Alcaide . Antonio . Matilla . Alfredo . Herrera . Enrique . Successful treatment of perforating granuloma annulare with 0.1% tacrolimus ointment . Journal of Dermatological Treatment . Informa UK Limited . 19 . 6 . January 1, 2008 . 0954-6634 . 10.1080/09546630802132650 . 376–377 . 18608717 . 28009992 . none.
• Peñas . Pablo F. . Jones-Caballero . María . Fraga . Javier . Sánchez-Pérez . Javier . García-Díez . Amaro . Perforating granuloma annulare . International Journal of Dermatology . Wiley . 36 . 5 . 1997 . 0011-9059 . 10.1046/j.1365-4362.1997.00047.x . 340–348 . 9199980 . 24831501 . none.

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. Jacob . Joanne S . Krenek . Gregory . Tschen . Jaime . Perforating Granuloma Annulare Mimicking Psoriasis . Cureus . Cureus, Inc. . August 24, 2020 . 12 . 8 . e9983 . 2168-8184 . 10.7759/cureus.9983 . free . 32983684 . 7511076 .
3. Alves . João . Barreiros . Hugo . Bártolo . Elvira . Perforating Granuloma Annulare — An Unusual Subtype of a Common Disease . Healthcare . MDPI AG . 2 . 3 . September 4, 2014 . 2227-9032 . 10.3390/healthcare2030338 . free . 338–345. 27429281 . 4934595 .
4. Witkoff . Benjamin M. . Ivanov . Nedyalko N. . Trotter . Shannon C. . Perforating Granuloma Annulare Appearing as a Psoriasiform Lesion . Case Reports in Dermatology . S. Karger AG . 11 . 2 . August 6, 2019 . 1662-6567 . 10.1159/000501875 . 233–238. 31543770 . 6738183 .