Annular Elastolytic Giant Cell Granuloma Occurring in Covered Areas

Abstract

A 72-year-old male had 7 erythematous infiltrated areas of 3–7 cm in diameter on the sun-unexposed areas, i.e., the chest, abdomen and inguinal region. While the centers of the lesions were flat and slightly reddish or normal skin-colored, the margins were flesh-colored and elevated, and the lesions were generally annular or of letter C form. An old lesion on the nucha was depigmented, slightly depressed and soft on palpation. Histological sections revealed giant cell granuloma with loss of elastic fibers.

Successful Therapy of Annular Elastolytic Giant Cell Granuloma with Fumaric Acid Esters

“…This is emphasized by the term 'actinic granuloma', which has been coined to describe a similar entity [5]. However, cases with systemic involvement [7] and with lesions in non-sun-exposed areas [6,8,9] as well as lesions with only moderate or absent solar elastosis [1, 10] have been described. Therefore, the term AEGCG appears to be more appropriate than actinic granuloma for the designation of this entity since other (unknown) factors than UV light altering elastic fibers might also play a role in the pathogenesis of this skin disease [6].…”

Annular Elastolytic Giant Cell Granuloma - A Rare Case with Systemic Involvement

“…The most common clinical presentation consists of annular plaques or patches often with elevated borders and central atrophy 4 , Clinically, AEGCG presents as multiple, large, annular plaques with a raised, erythematous border and central atrophy. The lesions are mostly located on sun-exposed areas such as the face and neck, but they are also seen on nonexposed skin although rare reports of a papular variant of AEGCG exist 5,6 Case report: A forty year old female patient was referred to us from medicine department with multiple asymptomatic scaly skin lesions. She noticed these lesions since last five years.…”

Generalised Annular Elastolytic Giant Cell Granuloma

“…AEGCG is clinically characterised by annular patches with erythematous borders and hypopigmented centres showing atrophic wrinkling. AEGCG is mostly found in middle-aged white females and the lesions are mainly located in sun-exposed areas and less frequently also on covered skin [2,3]. On histology, the granulomatous infiltrate is patchy or diffuse and contains numerous multinucleated giant cells, in addition to histiocytes and lymphocytes.…”

“…In a few patients, however, clinical and histological variations of this prototypical presentation of AEGCG have been described. AEGCG may predominantly affect covered skin areas or may consist of papular rather than ring-shaped lesions [2,8,9]. In another case, there was a remarkable multitude of lesions (hundreds) in sun-exposed and unexposed areas [4].…”

“…Altogether, chloroquine treatment failed in 3 cases and showed a partial effect in another 3 cases [1]. A few patients were treated without success by cryotherapy [22], cauterisation [23], topical steroids [1,2], PUVA [1,19] and methotrexate [18]. The therapy of AEGCG remains unsatisfactory, and various treatment options have to be considered for patients with this rather rare disease.…”