Khanna Urmi, North Jeffrey P
Department of Dermatology, University of California, San Francisco, California, USA.
Department of Pathology, University of California, San Francisco, California, USA.
J Cutan Pathol. 2020 Sep;47(9):785-793. doi: 10.1111/cup.13707. Epub 2020 Apr 27.
Granuloma annulare (GA) is a skin disorder of uncertain etiology. Patch (type) GA is an uncommon variant of GA with a paucity of data characterizing it. We describe the features of 23 cases of patch GA.
The archives of dermatopathology were searched for cases of patch GA. The clinical history and morphology for each patient were reviewed. Only cases with patch clinical morphology were included. The clinical and histopathologic features were assessed including the pattern of granulomatous inflammation and presence of other inflammatory cell types.
Most patients were female (19/23) with erythematous patches on the trunk and proximal extremities. The most common clinical differential diagnosis included mycosis fungoides (MF), morphea and contact dermatitis. Dyslipidemia was the most common comorbidity (30%), followed by diabetes (15%) and hypertension (15%). Histopathologic features included interstitial lymphocytes and histiocytes with dermal mucin. Two cases showed focal palisaded granulomas. Eosinophils and plasma cells were present in 1/3 of cases.
Patch GA is an uncommon GA variant with an interstitial granulomatous histopathologic pattern that predominantly affects women over 50. It can mimic interstitial MF and early morphea both clinically and histopathologically. Awareness of this GA variant can help prevent misdiagnosis and inappropriate treatment for these patients.
环状肉芽肿（GA）是一种病因不明的皮肤疾病。斑片型GA是GA的一种罕见变体，关于其特征的数据较少。我们描述了23例斑片型GA的特征。
在皮肤病理学档案中查找斑片型GA病例。回顾了每位患者的临床病史和形态学。仅纳入具有斑片临床形态的病例。评估了临床和组织病理学特征，包括肉芽肿性炎症模式和其他炎症细胞类型的存在情况。
大多数患者为女性（19/23），躯干和近端肢体出现红斑性斑片。最常见的临床鉴别诊断包括蕈样肉芽肿（MF）、硬斑病和接触性皮炎。血脂异常是最常见的合并症（30%），其次是糖尿病（15%）和高血压（15%）。组织病理学特征包括间质淋巴细胞和组织细胞以及真皮黏液。2例显示局灶性栅栏状肉芽肿。三分之一的病例中有嗜酸性粒细胞和浆细胞。
斑片型GA是一种罕见的GA变体，具有间质肉芽肿性组织病理学模式，主要影响50岁以上的女性。它在临床和组织病理学上都可模仿间质型MF和早期硬斑病。认识这种GA变体有助于防止对这些患者的误诊和不适当治疗。
