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. 2009 May;21(2):113-9.
doi: 10.5021/ad.2009.21.2.113. Epub 2009 May 31.

Clinical and pathological features of generalized granuloma annulare with their correlation: a retrospective multicenter study in Korea

Jeong Hyun Yun  1 , Ji Yeoun Lee, Mi Kyeong Kim, Young Joon Seo, Myung Hwa Kim, Kwang Hyun Cho, Moon Bum Kim, Won Soo Lee, Kwang Hoon Lee, You Chan Kim, Seok Jong Lee, Gwang Seong Choi, Young Ho Won, Chull Wan Ihm, Tae Young Yoon
Affiliations

Clinical and pathological features of generalized granuloma annulare with their correlation: a retrospective multicenter study in Korea

Jeong Hyun Yun et al. Ann Dermatol. 2009 May.

Abstract

Background: Generalized granuloma annulare (GGA) is a benign skin disorder of an unknown etiology. Though some cases of GGA have been reported, few systemic reviews of the clinical and pathological features of GGA have been performed.

Objective: The purpose of this study is to analyze and correlate the clinical and pathological characteristics of GGA in Korean patients.

Methods: We conducted a retrospective study that included 54 biopsy specimens of Korean GGA patients, and the clinical and pathological features of GGA were reviewed and analyzed for their correlation.

Results: The cutaneous lesions could be divided into the annular (24, 44%) and nonannular types (30, 56%), and the lesions were more common in males than in females (29 males and 25 females). The incidence of GGA showed a bimodal age distribution. The number of patients who presented within the first decade was 24 cases (44%), and 24 cases (44%) were over the fifth decade. Eight patients (15%) had systemic diseases. Especially, diabetes mellitus (DM) occurred only in the adult GGA patients over forty years old. The pathological findings showed dermal granulomatous lesions that consisted of either a palisading pattern (28, 52%) or an interstitial pattern (26, 48%).

Conclusion: In contrast to the previously reported studies, the age of GGA onset showed a bimodal distribution, and GGA was observed more often in males. The prevalence of DM in the GGA affected individuals was higher than that found in the general Korean population. Therefore, it is recommended to perform a work-up for DM in the GGA affected patients who are over forty years old.

Keywords: Clinical; Generalized granuloma annulare; Pathological.

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Figures

Fig. 1
Fig. 1
Distribution of the cases according to the age of onset.
Fig. 2
Fig. 2
Widespread annular polycyclic erythematous plaques on the trunk.
Fig. 3
Fig. 3
Numerous match head-sized erythematous papules over the entire body.
Fig. 4
Fig. 4
A palisading pattern granuloma with a central zone of necrobiotic collagen surrounded by a palisade of histiocytes and some lymphocytes (H&E, ×100).
Fig. 5
Fig. 5
An interstitial pattern granuloma with an infiltrate of histiocytes between collagen bundles (H&E, ×200).
Fig. 6
Fig. 6
Structural patterns of the annular and nonannular types.
Fig. 7
Fig. 7
Alcian blue pH 2.5 staining showed the deposition of increased bluish material among the degenerated collagen fibers (×200).
See this image and copyright information in PMC

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