Ran Cai Zhuo, Mamet Françoise, Kokta Viktor, Coulombe Jérôme
Division of Dermatology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada.
Department of Pediatrics, Centre Intégré de Santé et de Services Sociaux de l'Abitibi-Témiscamingue, Amos, QC, Canada.
SAGE Open Med Case Rep. 2020 Jun 27;8:2050313X20935713. doi: 10.1177/2050313X20935713. eCollection 2020.
Deep granuloma annulare is an uncommon benign granulomatous skin disorder that presents almost exclusively in the paediatric population. It presents as an asymptomatic subcutaneous nodule with normal overlying skin on distal extremities, the scalp, or the forehead. It shows a deep palisading granuloma with areas of central necrobiosis on histologic examination. Due to its self-limited nature, clinical follow-up is recommended over surgical interventions. We present a case of cephalic deep granuloma annulare in a healthy 5-year-old girl who remains free of recurrence after surgical excision at the 6-month follow-up. Our case emphasizes the importance of differentiating the lesion from its clinical and histopathological mimickers, such as the rheumatoid nodule. The awareness of this entity is important to avoid the overinvestigation and overtreatment of a benign and self-limited disease.
深部环状肉芽肿是一种罕见的良性肉芽肿性皮肤病，几乎仅见于儿童群体。其表现为无症状的皮下结节，位于远端肢体、头皮或前额，其上覆皮肤正常。组织学检查显示为深部栅栏状肉芽肿，伴有中央渐进性坏死区域。由于其自限性，建议进行临床随访而非手术干预。我们报告一例健康5岁女童的头部深部环状肉芽肿病例，在6个月的随访中，手术切除后未复发。我们的病例强调了将该病变与其临床和组织病理学相似疾病（如类风湿结节）相鉴别的重要性。认识到这一实体对于避免对一种良性自限性疾病进行过度检查和过度治疗很重要。
