1/132. Actinically degenerate elastic tissue is the likely antigenic basis of actinic granuloma of the skin and of temporal arteritis. Staining technique is paramount for detecting and assessing the severe degeneration that occurs in the elastic tissues of the skin and its arteries in response to prolonged exposure to actinic radiation. With a selective "controlled" hematoxylin-and-eosin stain, actinically damaged ("elastotic") elastic tissue stains blue, as Unna described, and contrasts with normal and simply hyperplastic elastic tissue, which stains red. "Special" elastic stains such as Orcein and Verhoeff do not demonstrate this difference. When resorptive (elastolytic) giant cell reactions develop in relation to actinically degenerate elastic tissue of the skin, the papules that arise tend to form expanding, annular rings. A previously used and appropriate name for these autoimmune lesions in the skin is actinic granuloma because this name highlights the likely actinic origin and pathogenesis of many such lesions. Granulomatous inflammation in connection with actinically degenerate internal elastic lamina appears to be the basis of temporal arteritis. Actinic granulomas may occur in the skin concurrently with temporal arteritis. A recent study of temporal arteritis strongly relates its elastic tissue changes to those of "accelerated" atherosclerosis. ( info) |
| granuloma annulare (GA) is a condition characterized by the presence of palisading granulomas usually in the dermis. Traditionally, the histopathological changes are described as consisting of focal degeneration of dermal collagen fibers. However, no convincing evidence for such alteration is found in the literature. A histopathological study was done to ascertain the nature of the dermal abnormality. Ten skin biopsies showing lesions of GA were studied by light and electron microscopy. On light microscopy, all lesions showed focal dermal degeneration with near total loss of elastic fibers. Ultrastructural examination in nine cases demonstrated degenerated elastic fibers with loss of peripheral microfibrils and abnormal elastic matrix. The degenerated elastic fibers were surrounded by intact collagen fibers. These findings show that the main alteration in GA is elastic fiber degeneration and strongly suggest that the primary target leading to the development of this disorder is injury to the elastic tissue. ( info) |
3/132. Coexisting morphoea and granuloma annulare-are the conditions related? granuloma annulare and localized morphoea are both well described in the dermatological literature. We now present two patients with both of these diseases, a comorbidity rarely described. A possible pathogenic relationship is discussed. ( info) |
| granuloma annulare typically affects the hands and the feet, sparing the volar surfaces. A case of granuloma annulare localized to the palms is described. ( info) |
| A case of granuloma annulare (GA) localised to the shaft of the penis is reported with a brief review of the current literature. We concluded that penile GA, although rare, should be considered in the differential diagnosis of granulomatous lesions of the penis and that histopathological examination of the lesion is essential for the diagnosis. ( info) |
| granuloma annulare is a benign, relatively common dermatosis of childhood. Lesions typically occur on the extremities and resolve spontaneously over a period of several months to years. Localized facial involvement is rare. We report a case of granuloma annulare confined to the left eyelid. The literature on periocular granuloma annulare is reviewed. This diagnosis should be considered for any acquired papules of the periorbital area, especially if there is a history of antecedent trauma. Unnecessary surgical excision can then be avoided. ( info) |
7/132. Deep dermal granuloma annulare presenting as an eyelid tumor in a child, with review of pediatric eyelid lesions. A case of deep dermal granuloma annulare (GA) involving the eyelid of a child is reported. GA presenting in the periocular region is rare and may mimic other lesions. The differential diagnosis of pediatric eyelid lesions is reviewed. ( info) |
8/132. Papular elastolytic giant cell granuloma: a clinical variant of annular elastolytic giant cell granuloma or generalized granuloma annulare? A 71-year-old man with asymptomatic red papules on the trunk and upper arms was reported as a case of papular elastolytic giant cell granuloma. A skin biopsy specimen from a papule on the back showed similar findings to those of annular elastolytic giant cell granuloma. However, centrifugal annular lesions were not clinically observed. He was successfully treated with tranilast and topical steroids. ( info) |
9/132. Generalised granuloma annulare successfully treated with PUVA. Disseminated granuloma annulare is an uncommon disorder in which both topical and systemic therapy may have limited success. Anecdotal reports have suggested that PUVA may result in complete clearance of disease; however, maintenance puva therapy has usually been required in order to maintain remission. We report the successful treatment of a patient with 5-methoxypsoralen over a 7-month period who remained in remission during a 20-month follow up period. ( info) |
| anetoderma is a rare disorder of cutaneous atrophy with loss of dermal elastic tissue. Secondary anetoderma is seen after a variety of dermatoses. We describe a 33-year-old woman with secondary anetoderma after generalized granuloma annulare lesions that were most pronounced on sun-exposed areas. ( info) |