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Interstitial granulomatous dermatitis with plaquesL92.1
Synonym(s)
Interstitial granulomatous dermatitis with arthritis (Ackerman); Interstitial granulomatous drug reaction
HistoryThis section has been translated automatically.
Ackerman, 1991
DefinitionThis section has been translated automatically.
Etiologically unexplained granulomatous dermatitis, which occurs in connection with other autoimmune diseases or diseases of the rheumatic form. The differentiation from granulomatosis disciformis chronica et progressiva has not been made so far.
EtiopathogenesisThis section has been translated automatically.
Unknown; blamed are traumas, medication, infections. Discussed is the deposition of immune complexes in the walls of dermal vessels, which in turn lead to collagen degeneration and consecutive inflammatory reaction.
ManifestationThis section has been translated automatically.
Mostly in non-diabetics. Middle adulthood (3rd - 8th decade of life). Women are more frequently affected than men.
LocalizationThis section has been translated automatically.
Buttocks, body folds, lateral chest, abdomen. Mostly symmetrical arrangement of the skin lesions.
Clinical featuresThis section has been translated automatically.
Chronic (duration > 6 weeks). Several (< 10) to multiple, rarely solitary, 3-18 cm large, round to oval, slowly centrifugally growing, partly confluent, mostly asymptomatic or slightly burning, plate-like, bizarrely configured, red to reddish brown plaques with partly yellowish parts and telangiectasia as well as atrophic surface.
LaboratoryThis section has been translated automatically.
The SPA is accelerated (average 25/86). Rheumatoid factor is positive in 10% of cases, ANA is pos. in 25% of cases Occasionally, anti-DNA-AK and thyroid-AK are also positive.
HistologyThis section has been translated automatically.
Interstitial epithelioid cell granulomas with a few giant cells and some neutrophil or eosinophilic leukocytes grouped around smaller necrobiosis zones.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
- Restrained approach, systemic therapy is not necessary.
- Glucocorticoid-containing external preparations such as 0.1% triamcinolone cream(e.g. Delphicort, R259 ) or 0.1% betamethasone ointment(e.g. Betagalen) and foil dressings, injection of glucocorticoid crystal suspension intrafocally (e.g. Volon A 10 mg, 1:3-1:5 diluted with the local anaesthetic scandicain).
- For small foci, excision if necessary.
Progression/forecastThis section has been translated automatically.
Mostly chronic progressive course; very rarely spontaneous healing.
LiteratureThis section has been translated automatically.
- Ackerman AB et al (1991) Clues to diagnosis in dermatopathology. In: Am Soc Clin Pathol Press, Chicago, Vol. 3, pp. 309-312
- Banuls J et al (2003) Interstitial granulomatous dermatitis with plaques and arthritis. Eur J Dermatol 13: 308-310
- Long D et al (1996) Interstitial granulomatous dermatitis with arthritis. J Am Acad Dermatol 34: 957-961
- Magro CM et al (1998) The interstitial granulomatous drug reaction: a distinctive clinical and pathological entity. J Cutan Pathol 25: 72-78
- Sangueza OP et al (2002) Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis. J Am Acad Dermatol 47: 251-257
- Tomasini C, Pippione M (2002) Interstitial granulomatous dermatitis with plaques. J Am Acad Dermatol 46: 892-899
- Wollina U et al (2003) Interstitial granulomatous dermatitis with plaques and arthritis. Clin Rheumatol 22: 347-349