Granuloma actinic L92.2

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

actinic granuloma; Actinic granuloma; AEGCP; annular elastolytic giant cell granuloma; atypical necrobiosis lipoidica fo the face and scalp; giant cell elastophagocytosis; Miescher`s granuloma of the face

History
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O'Brian, 1975

Definition
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First described by O'Brian as a giant cell containing granuloma at the bottom of an actinic damage. Later investigations cast doubt on the validity of chronic UV damage as a triggering agent. Furthermore, it was shown that this disease had already been described under other names before O'Brian (see above). As variants (or also synonymously) the granuloma multiforme and the granuloma anulare are regarded. The anular elastolytic giant cell granuloma may also be regarded as synonymous with actinic granuloma.

Manifestation
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From the age of 40. Women preferentially affected. All races are affected.

Localization
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Light, infrared or heat damaged skin areas, especially the face.

Clinical features
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Slightly itchy, skin-coloured to red or reddish-brown, non-scalying, firm papules and plaques, which may slowly expand centrifugally and may form confluent annular or circulatory formations. The centre of the plaques is usually atrophied and the edges prominently palpable. The changes can also occur in the area of the conjunctiva. In a larger collective, diabetes mellitus was detected in 40% of patients (Gutiérrez-González E et al. 2015).

Histology
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Sarcoid granulomas with giant cells and amorphously deposited elastotic material in the upper dermis.

Therapy
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Progression/forecast
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Healing mostly after several years.

Literature
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  1. Al-Hoqail IA et al (2002) Actinic granuloma is a unique and distinct entity: a comparative study with granuloma annulare. At J Dermatopathol 24: 209-212
  2. Gutierrez-Gonzalez E et al (2013) Elastolytic giant cell granuloma: clinic-pathologic review of twenty cases. Dermatol Online J 19:20019

  3. Gutiérrez-González E et al (2015) Elastolytic Actinic Giant Cell Granuloma. Dermatol Clin 33:331-341.

  4. Konar K et al (2014) Annular elastolytic giant cell granuloma of conjunctiva: a case report. Indian J Ophthalmol 62:361-363

  5. Lim DS, Triscott J (2003) O'Brien's actinic granuloma in association with prolonged doxycycline phototoxicity. Australas J Dermatol 44: 67-70
  6. Limas C et al (2004) The spectrum of primary cutaneous elastolytic granulomas and their distinction from granuloma annulare: a clinicopathological analysis. Histopathology 44: 277-282
  7. McGrae JD (1986) Actinic Granuloma. Arch Dermatol 122: 43-47
  8. O'Brian JP (1975) Actinic granuloma. An annular connective tissue disorder affecting sun- and heat-damaged (elastotic) skin. Arch Dermatol 111: 460-466
  9. Ragaz A et al (1979) Is actinic granuloma a specific condition? At J Dermatopathol 1: 43-50
  10. Steinhoff M et al (2001) Figurated plaque on actinically damaged skin. Actinic O'Brien granuloma. dermatologist 52: 551-553

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Last updated on: 29.10.2020