Actinic Granuloma with Focal Segmental Glomerulosclerosis

Abstract

Actinic granuloma is an uncommon granulomatous disease, characterized by annular erythematous plaque with central clearing predominately located on sun-damaged skin. The pathogenesis is not well understood, ultraviolet radiation is recognized as precipitating factor. We report a case of a 52-year-old woman who presented with asymptomatic annular erythematous plaques on the forehead and both cheeks persisting for 2 years. The clinical presentation and histopathologic findings support the diagnosis of actinic granuloma. During that period of time, she also developed focal segmental glomerulosclerosis. The association between actinic granuloma and focal segmental glomerulosclerosis needs to be clarified by further studies.

Annular Elastolytic Giant Cell Granuloma

“…The most commonly reported risk factor is intense sun exposure/tanning beds and is more commonly seen in fair-skinned individuals [ 15 ] residing in a sunny climate. Other possible predisposing conditions and associations include diabetes mellitus (DM), sarcoidosis [ 7 ], giant cell arteritis [ 5 ], polymyalgia rheumatica, polychondritis, vitiligo [ 3 , 9 ], anemia, leukopenia, hepatitis C, focal segmental glomerulosclerosis, Hashimoto's thyroiditis [ 16 ], erythema nodosum [ 17 ] and protoporphyria [ 18 ]. A list of possible differentials for our patient included photodermatoses (lack of suggestive histopathologic findings in this patient rules it out), granuloma annulare, necrobiosis (lack of evidence of DM), drug-induced photosensitivity (lack of consumption of associated medications), dermal manifestations of auto-immune disorders, such as systemic lupus erythematosus (negative ANA titer).…”