Srouji Zainab, Salem Najem, Ghwich Rama, Mounla Munir, Abdul Rahman Noura
Faculty of Medicine, University of Aleppo, Aleppo, Syria.
Department of Dermatology and Venereology, Faculty of Medicine, University of Aleppo, Aleppo, Syria.
Ann Med Surg (Lond). 2025 Jul 25;87(9):6173-6176. doi: 10.1097/MS9.0000000000003642. eCollection 2025 Sep.
Granuloma annulare (GA) is a benign, self-limited, chronic inflammatory dermatosis predominantly affecting children and young adults. Subcutaneous granuloma annulare (SGA) is a rare variant, chiefly observed in children, characterized by firm, asymptomatic nodules typically located on the lower extremities, buttocks, or scalp. Involvement of the palms or soles is exceptionally rare.
We report the case of a healthy teenager presenting with bilateral subcutaneous nodules on both the palmar and dorsal surfaces of the hands. Histopathological examination confirmed the diagnosis of SGA. Given the patient's aesthetic concerns, a treatment regimen of intralesional corticosteroid injections was initiated, leading to complete resolution of the lesions without recurrence during follow-up.
This case represents the first documented instance of SGA involving both palmar and dorsal surfaces of the hands bilaterally in a healthy adolescent. While SGA is usually self-limited, cosmetic concerns or discomfort may necessitate therapeutic intervention. Intralesional corticosteroids have been employed with variable success in such cases.
This case underscores the importance of considering SGA in the differential diagnosis of subcutaneous hand nodules in pediatric patients, even in atypical locations such as the palms and dorsal hands. It also highlights the efficacy of intralesional corticosteroid treatment in achieving satisfactory cosmetic outcomes without recurrence.
环状肉芽肿（GA）是一种主要影响儿童和年轻人的良性、自限性慢性炎症性皮肤病。皮下环状肉芽肿（SGA）是一种罕见的变异型，主要见于儿童，其特征为通常位于下肢、臀部或头皮的坚实、无症状结节。手掌或足底受累极为罕见。
我们报告一例健康青少年病例，其双手掌面和背面均出现双侧皮下结节。组织病理学检查确诊为SGA。考虑到患者的美观需求，开始采用皮损内注射皮质类固醇的治疗方案，皮损完全消退，随访期间无复发。
该病例是文献记载的首例健康青少年双侧手掌面和背面均累及的SGA。虽然SGA通常是自限性的，但出于美观考虑或不适可能需要进行治疗干预。皮损内注射皮质类固醇在这类病例中的疗效不一。
该病例强调了在儿科患者皮下手部结节的鉴别诊断中考虑SGA的重要性，即使在手掌和手背等非典型部位。它还突出了皮损内注射皮质类固醇治疗在实现满意的美容效果且无复发方面的疗效。
