Dermatology Unit, Department of Health Sciences, University of Florence, Florence, Italy.
Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Morgagni 50, 50134 Florence, Italy.
Biomed Res Int. 2020 Sep 30;2020:3281380. doi: 10.1155/2020/3281380. eCollection 2020.
Granuloma annulare (GA) and interstitial granulomatous dermatitis (IGD) are granulomatous dermatoses with variable clinical appearances. GA is associated with diabetes mellitus, metabolic syndrome, chronic infections, and malignancies, while two Japanese reports described unusual cases of interstitial-type GA in setting of Sjogren syndrome. IGD was associated with rheumatoid arthritis, systemic lupus erythematosus, and autoantibodies. We report a case series of six patients with GA or IGD. Half of the patients were diagnosed with Sjogren syndrome, while all of them presented ANA positivity and the majority reported arthralgia. In many cases, GA showed interstitial-type histology, arising challenges in differential diagnosis with IGD. The overlap of clinical and histological features of GA and IGD can be explained considering them as a broad disease spectrum, including also the other forms of reactive granulomatous dermatitis. These conditions should be considered as an indicator of possible systemic disorders or other immunological dyscrasias, for which patients must be screened. Sjogren syndrome may be associated to GA also in Caucasians.
环状肉芽肿（GA）和间质性肉芽肿性皮炎（IGD）是具有不同临床表现的肉芽肿性皮肤病。GA 与糖尿病、代谢综合征、慢性感染和恶性肿瘤有关，而两份日本报告描述了 Sjogren 综合征背景下间质性 GA 的不常见病例。IGD 与类风湿关节炎、系统性红斑狼疮和自身抗体有关。我们报告了六例 GA 或 IGD 患者的病例系列。一半的患者被诊断为 Sjogren 综合征，而他们所有人的 ANA 均呈阳性，大多数人报告有关节痛。在许多情况下，GA 表现为间质性组织学，这在与 IGD 的鉴别诊断中带来了挑战。考虑到 GA 和 IGD 的临床和组织学特征存在重叠，可将它们视为广泛的疾病谱，包括其他形式的反应性肉芽肿性皮肤病。这些疾病应被视为可能存在系统性疾病或其他免疫功能紊乱的指标，患者必须接受筛查。在高加索人中，GA 也可能与 Sjogren 综合征有关。
