Clinical and Histopathological Evaluation of Forty-one Cases of Pediatric Granuloma Annulare

Abstract

Introduction: Granuloma annulare (GA) is a non-infectious granulomatous disease that can affect children and adults. Although many studies have been conducted adult GA patients, the literature on pediatric GA cases is limited. Objectives: Therefore, this study aimed to examine the demographic, clinical, and pathological features of pediatric GA cases. Methods: This study was performed retrospectively in a single-center tertiary dermatology hospital. Demographic characteristics and clinical and histopathological features were recorded. Results: Forty-one participants were included in this study, of which 66% were female. The mean age was 3.8 ± 2.6 years, and the mean lesion duration was 7.5 ± 10.3 months. The involvement of 78% of the patients was localized, and the remaining 22% was generalized. Asthma (30%) was the most common comorbid disease. Histopathological examination was performed on twenty-one patients, and the infiltrate pattern was interstitial in 71% of the cases and palisadic in 29%. Generalized distribution, trunk involvement, and concomitant disease tended to be higher in patients with an interstitial pattern than in those with a palisadic pattern. Conclusions: Atopy and asthma should be questioned in pediatric GA cases. There are differences between involvement, distribution, concomitant disease, and histopathological patterns, which may indicate differences in pathogenesis.

Clinicopathologic evaluation of granuloma annulare: Study of 136 Iranian cases, south of Iran

“…18 In our study, 41.9% of patients had eosinophil that is higher than what other researchers observed in their studies (3.7%-38%). 16,[18][19][20][21] The possibility of insect bite or drug reactions are proposed as the causes of eosinophil-rich GA (20). Giant cells (43.3%) were less frequent than some of the studies (57%-90%), 16,[18][19][20] but higher than some other studies (15.9%).…”

“…16,[18][19][20][21] The possibility of insect bite or drug reactions are proposed as the causes of eosinophil-rich GA (20). Giant cells (43.3%) were less frequent than some of the studies (57%-90%), 16,[18][19][20] but higher than some other studies (15.9%). 21 We detected plasma cells in 38.2% of our patients.…”

“…16,18 Malignancy-associated and childhood GA also presented on the extremities in most patients. 18,19 In most of the studies that assessed the histopathologic findings of GA, interstitial pattern was the more common type of GA and 33%-71% of cases demonstrated this pattern. 11,16,17,19,20 However, Cheng et al 21 showed palisading histiocytes as a predominant type of infiltration in GA (63.6%).…”

“…18,19 In most of the studies that assessed the histopathologic findings of GA, interstitial pattern was the more common type of GA and 33%-71% of cases demonstrated this pattern. 11,16,17,19,20 However, Cheng et al 21 showed palisading histiocytes as a predominant type of infiltration in GA (63.6%). Also, necrobiotic GA was slightly more than the interstitial and mixed types in the GA cases not associated with malignancy.…”

“…18 Mucin was observed in all of our cases in haematoxylin and eosin (H&E) stain; however, in previous studies it was reported in 61%-93%. 16,[19][20][21] The difference between studies may be the result of detection of mucin in the H&E or mucin special stains. Mucin was detected more frequently in the complete type of GA, compared to the interstitial GA, both in our and previous studies.…”