Department of Dermatology, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Am J Clin Dermatol. 2010;11(3):171-81. doi: 10.2165/11530080-000000000-00000.
Non-infectious granulomatous diseases of the skin are a broad group of distinct reactive inflammatory conditions that share important similarities. As a group, they are relatively difficult to diagnose and distinguish both clinically as well as histologically. Many of these disorders have significant associations with systemic diseases that impact the patient's overall prognosis. In this update, we offer a discussion of emerging concepts and controversies in this field, as presented through evidence-based answers to seven important clinical questions regarding palisading and epithelioid granulomata. These questions offer an opportunity to review ten non-infectious granulomatous conditions that have implications for systemic disease: granuloma annulare, annular elastolytic giant cell granuloma, necrobiosis lipoidica, methotrexate-induced accelerated rheumatoid nodulosis, necrobiotic xanthogranuloma, interstitial granulomatous dermatitis, interstitial granulomatous drug reaction, palisaded neutrophilic granulomatous dermatitis, sarcoidosis, and metastatic Crohn disease. Recent clinical, epidemiologic, and laboratory studies have shed some light on these diseases, the association of these conditions with systemic disorders, and their overall prognoses.
非感染性皮肤肉芽肿性疾病是一组广泛的不同的反应性炎症性疾病，它们具有许多重要的相似之处。作为一组疾病，它们在临床上和组织学上都相对难以诊断和鉴别。许多这些疾病与影响患者整体预后的系统性疾病有显著关联。在本次更新中，我们通过对七个关于栅栏状和上皮样肉芽肿的重要临床问题的循证解答，讨论了该领域的新出现的概念和争议。这些问题为回顾十种具有系统性疾病相关性的非感染性肉芽肿性疾病提供了机会：环状肉芽肿、环状弹性纤维溶解巨细胞肉芽肿、类脂质渐进性坏死、甲氨蝶呤诱导的加速类风湿结节病、坏死性黄色肉芽肿、间质性肉芽肿性皮炎、间质性肉芽肿性药物反应、栅栏状中性粒细胞性肉芽肿性皮炎、结节病和转移性克罗恩病。最近的临床、流行病学和实验室研究为这些疾病、这些疾病与系统性疾病的关联以及它们的整体预后提供了一些线索。
