Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Jun;25(2):289-295.
doi: 10.1007/s40477-020-00532-0. Epub 2021 Jan 16.

Granuloma annulare subtypes: sonographic features and clinicopathological correlation

Nuria Rodríguez-Garijo  1 , Alejandra Tomás-Velázquez  1 , Angela Estenaga  1 , Javier Antoñanzas  1 , Maria Agustina Segurado-Rodríguez  2 , Laura García-Tobar  3 , Miguel Angel Idoate  3 , Francisco Javier García-Martínez  4   5   6
Affiliations
Observational Study

Granuloma annulare subtypes: sonographic features and clinicopathological correlation

Nuria Rodríguez-Garijo et al. J Ultrasound. 2022 Jun.

Abstract

Purpose: Diagnosis of granuloma annulare (GA) is based on the clinical and histopathological findings. However, only sporadic case reports of subcutaneous GA sonography have been published to date. The objective of this study was to evaluate the ultrasonographic patterns of the different clinical variants of GA: localized, generalized, subcutaneous, and perforating.

Methods: In this retrospective observational study, we analyzed and correlated the clinical, histopathological, and sonographic features of 15 patients diagnosed with GA.

Results: We included 8 women and 7 men with a mean age of 48.4 years (8-77 years). We found three different sonographic patterns depending on the clinical variant of GA: poorly defined hypoechoic band including the dermis (dermal pattern), irregularly shaped hypoechoic hypodermal lumps (hypodermal pattern), and ill-defined hypoechoic dermal and subcutaneous lesions (mixed pattern). Five cases showed increased blood flow signal on Doppler interrogation.

Conclusion: Although our findings are broadly consistent with the previous reports of subcutaneous GA, the sonographic features in localized, generalized, and perforating GA have not been previously reported.

Keywords: Cutaneous ultrasound; Diagnosis; Granuloma annulare; Pathology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Perforating granuloma annulare. a Erythematous plaque with central plugs of keratinaceous material on the left elbow. b Histologic image (Hematoxylin and Eosin, ×40) showing transepidermal elimination of collagenous debris surrounded by a palisaded granulomatous inflammatory infiltrate. c Ultrasound scans taken at 22 MHz show a poorly defined hypoechoic band with a prominent hyperechoic superficial dot with posterior acoustic shadowing. d Power Doppler showing intense flow signal
Fig. 2
Fig. 2
Localized annular granuloma annulare. a Erythematous annular plaque. b Histologic image (Hematoxylin and Eosin, ×40) showing a central zone of altered collagen, surrounded by a palisaded granulomatous inflammatory infiltrate. c Ultrasound scans taken at 22 MHz show double oval-shaped hypoechogenic bands in the superficial dermis
Fig. 3
Fig. 3
Sonographic patterns in granuloma annulare
See this image and copyright information in PMC

References

    1. Piette EW, Rosenbach M. Granuloma annulare: clinical and histologic variants, epidemiology, and genetics. J Am Acad Dermatol. 2016;75:457–465. doi: 10.1016/j.jaad.2015.03.054. - DOI - PubMed
    1. Piette EW, Rosenbach M. Granuloma annulare: pathogenesis, disease associations and triggers, and therapeutic options. J Am Acad Dermatol. 2016;75:467–479. doi: 10.1016/j.jaad.2015.03.055. - DOI - PubMed
    1. de Barcaui EO, Carvalho AC, Lopes FP, et al. High frequency ultrasound with color Doppler in dermatology. An Bras Dermatol. 2016;9:262–273. doi: 10.1590/abd1806-4841.20164446. - DOI - PMC - PubMed
    1. Echeverría-García B, Borbujo J, Alfageme F. The use of ultrasound imaging in dermatology. Actas Dermosifiliogr. 2014;105:887–890. doi: 10.1016/j.ad.2014.03.007. - DOI - PubMed
    1. Navarro OM. Soft tissue masses in children. Radiol Clin N Am. 2011;49:1235–1259. doi: 10.1016/j.rcl.2011.07.008. - DOI - PubMed

Publication types

LinkOut - more resources