Perforating Granuloma Annulare with Cysts and Comedones.

IF 1.6 Q3 DERMATOLOGY
Enric Piqué-Duran, Mikel Azcue-Mayorga, Belinda Roque-Quintana, Odalys García-Vázquez, Antonio Ruedas-Martínez
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Abstract

A 71-year-old Caucasian woman presented with lesions on both elbows. A physical examination revealed arcuate plaques with raised erythematous edges and central clearing. Comedones and cysts were evident on the border of the lesions. The dermatoscopic view showed the presence of pores, in addition to granuloma annulare changes. The biopsies showed changes according to granuloma annulare, but the granulomas were closely related to comedones and cysts. Furthermore, the presence of elastophagocytosis via multinucleated Langhans-type giant cells was evident. Verhoeff-van Gieson staining highlighted the transepithelial elimination of elastic fibers in the bottom of some cysts. The presence of comedones or cysts is exceptional in granuloma annulare. Only four similar cases have been reported. Although all previous cases showed lesions in sun-exposed areas over photodamaged skin, only our case showed transepithelial elimination of elastic fibers. Diabetes mellitus (DM) could play a role in the pathogenesis of this variant of actinic granuloma annulare, because most cases are associated with uncontrolled DM and the lesions improve after DM is controlled.

环状穿孔肉芽肿伴囊肿和粉刺。
一位71岁的白人女性,双肘病变。体格检查发现弓形斑块,边缘红斑凸起,中心清晰。病灶边缘可见明显的粉刺和囊肿。皮肤镜检查显示毛细孔的存在,除了肉芽肿环形改变。活检显示肉芽肿呈环形,但肉芽肿与粉刺和囊肿密切相关。此外,通过多核朗汉斯型巨细胞的噬弹性作用的存在是明显的。verhoefff -van Gieson染色突出了一些囊肿底部弹性纤维的经上皮消除。在环形肉芽肿中出现粉刺或囊肿是罕见的。仅有4例类似病例被报道。虽然所有以前的病例显示病变在阳光照射的区域超过光损伤的皮肤,只有我们的病例显示经上皮消除弹性纤维。糖尿病(DM)可能在这种光化性环形肉芽肿的发病机制中发挥作用,因为大多数病例与未控制的DM有关,并且在DM得到控制后病变得到改善。
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来源期刊
Dermatopathology
Dermatopathology DERMATOLOGY-
自引率
5.30%
发文量
39
审稿时长
11 weeks
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