Perforating granuloma annulare

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Perforating granuloma annulare
Specialty	Dermatology

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.: 704 

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. These papules are frequently arranged in an annular form and frequently have an exudate, crusting, or scaling covering them. 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.

Causes

The cause of perforating granuloma annulare is unknown.

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. Furthermore, the epidermis is perforated and necrobiotic material is expelled as a result of the granulomas' location in the superficial reticular dermis.

Treatment

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

See also

• Granuloma annulare
• Skin lesion

References

1. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
2. ^ a b Jacob, Joanne S; Krenek, Gregory; Tschen, Jaime (August 24, 2020). "Perforating Granuloma Annulare Mimicking Psoriasis". Cureus. 12 (8). Cureus, Inc.: e9983. doi:10.7759/cureus.9983. ISSN 2168-8184. PMC 7511076. PMID 32983684.
3. ^ a b c Alves, João; Barreiros, Hugo; Bártolo, Elvira (September 4, 2014). "Perforating Granuloma Annulare — An Unusual Subtype of a Common Disease". Healthcare. 2 (3). MDPI AG: 338–345. doi:10.3390/healthcare2030338. ISSN 2227-9032. PMC 4934595. PMID 27429281.
4. ^ a b Witkoff, Benjamin M.; Ivanov, Nedyalko N.; Trotter, Shannon C. (August 6, 2019). "Perforating Granuloma Annulare Appearing as a Psoriasiform Lesion". Case Reports in Dermatology. 11 (2). S. Karger AG: 233–238. doi:10.1159/000501875. ISSN 1662-6567. PMC 6738183. PMID 31543770.

Further reading

• Lopez-Navarro, Norberto; Castillo, Rosa; Gallardo, MarÍa A.; Alcaide, Antonio; Matilla, Alfredo; Herrera, Enrique (January 1, 2008). "Successful treatment of perforating granuloma annulare with 0.1% tacrolimus ointment". Journal of Dermatological Treatment. 19 (6). Informa UK Limited: 376–377. doi:10.1080/09546630802132650. ISSN 0954-6634. PMID 18608717. S2CID 28009992.
• Peñas, Pablo F.; Jones-Caballero, María; Fraga, Javier; Sánchez-Pérez, Javier; García-Díez, Amaro (1997). "Perforating granuloma annulare". International Journal of Dermatology. 36 (5). Wiley: 340–348. doi:10.1046/j.1365-4362.1997.00047.x. ISSN 0011-9059. PMID 9199980. S2CID 24831501.

External links

Classification	D ICD-11: EE80.0 ICD-10: L92.0 SNOMED CT: 402365006
External resources	Scholia: Q7168176

v t e Cutaneous keratosis, ulcer, atrophy, and necrobiosis
Epidermal thickening	keratoderma: Keratoderma climactericum Paraneoplastic keratoderma Acrokeratosis paraneoplastica of Bazex Aquagenic keratoderma Drug-induced keratoderma psoriasis Keratoderma blennorrhagicum keratosis: Seborrheic keratosis Clonal seborrheic keratosis Common seborrheic keratosis Irritated seborrheic keratosis Seborrheic keratosis with squamous atypia Reticulated seborrheic keratosis Dermatosis papulosa nigra Keratosis punctata of the palmar creases other hyperkeratosis: Acanthosis nigricans Confluent and reticulated papillomatosis Callus Ichthyosis acquisita Arsenical keratosis Chronic scar keratosis Hyperkeratosis lenticularis perstans Hydrocarbon keratosis Hyperkeratosis of the nipple and areola Inverted follicular keratosis Lichenoid keratosis Multiple minute digitate hyperkeratosis PUVA keratosis Reactional keratosis Stucco keratosis Thermal keratosis Viral keratosis Warty dyskeratoma Waxy keratosis of childhood other hypertrophy: Keloid Hypertrophic scar Cutis verticis gyrata
Necrobiosis/granuloma	Necrobiotic/palisading Granuloma annulare Perforating Generalized Subcutaneous Granuloma annulare in HIV disease Localized granuloma annulare Patch-type granuloma annulare Necrobiosis lipoidica Annular elastolytic giant-cell granuloma Granuloma multiforme Necrobiotic xanthogranuloma Palisaded neutrophilic and granulomatous dermatitis Rheumatoid nodulosis Interstitial granulomatous dermatitis/Interstitial granulomatous drug reaction Foreign body granuloma Beryllium granuloma Mercury granuloma Silica granuloma Silicone granuloma Zirconium granuloma Soot tattoo Tattoo Carbon stain Other/ungrouped eosinophilic dermatosis Granuloma faciale
Dermis/ localized CTD	Cutaneous lupus erythematosus chronic: Discoid Panniculitis subacute: Neonatal ungrouped: Chilblain Lupus erythematosus–lichen planus overlap syndrome Tumid Verrucous Rowell's syndrome Scleroderma/ Morphea Localized scleroderma Localized morphea Morphea–lichen sclerosus et atrophicus overlap Generalized morphea Atrophoderma of Pasini and Pierini Pansclerotic morphea Morphea profunda Linear scleroderma Atrophic/ atrophoderma Lichen sclerosus Anetoderma Schweninger–Buzzi anetoderma Jadassohn–Pellizzari anetoderma Atrophoderma of Pasini and Pierini Acrodermatitis chronica atrophicans Semicircular lipoatrophy Follicular atrophoderma Linear atrophoderma of Moulin Atrophia maculosa varioliformis cutis Perforating Kyrle disease Reactive perforating collagenosis Elastosis perforans serpiginosa Perforating folliculitis Acquired perforating dermatosis Skin ulcer Pyoderma gangrenosum Other Calcinosis cutis Sclerodactyly Poikiloderma vasculare atrophicans Ainhum/Pseudo-ainhum