Erythema elevatum diutinum - a chronic leukocytoclastic vasculitis microscopically indistinguishable from granuloma faciale?

Ziemer, Mirjana; Koehler, Martin; Weyers, Wolfgang

doi:10.1111/j.1600-0560.2011.01760.x

Cited by 34 publications

(28 citation statements)

References 42 publications

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“…However, it is known that these changes present in a very similar pattern in two entities, not being sufficient for differentiation. 4 All the patients in this study had facial lesions. Most samples entailed a typical, perivascular, inflammatory pattern.…”

Section: Discussionmentioning

confidence: 90%

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Granuloma faciale: clinical, morphological and immunohistochemical aspects in a series of 10 patients

Oliveira

Ianhez²,

Marques

et al. 2016

An. Bras. Dermatol.

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Granuloma faciale is a chronic, benign, cutaneous vasculitis with well-established clinical and morphological patterns, but with an unknown etiology. This study describes clinical and pathologic aspects of patients diagnosed with granuloma faciale. The authors analyzed demographic, clinical, morphological and immunohistochemical data from patients with a final diagnosis of granuloma faciale, confirmed between 1998 and 2012. There was a proportional and mixed inflammatory infiltrate, Grenz zones were present in almost all the samples. Immunophenotyping confirmed a higher intensity of T lymphocytes than B lymphocytes in thirteen samples, with a predominance of T CD8 lymphocytes in 64% of cases, in contrast to the literature, which indicates that the major component is T CD4 lymphocytes. All cases were positive for IgG4 but the majority (12/14) had less than 25% of stained cells. The pathogenesis of granuloma faciale remains poorly understood, making studies of morphological and immunohistochemical characterization important to better understand it.

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Section: Discussionmentioning

confidence: 90%

“…15 Immunohistochemical analysis of samples from this study revealed a superiority of CD8+ T cells compared with CD4+ T lymphocytes, differing from the current literature. 3,4,5,6,7,12 …”

Section: Discussionmentioning

confidence: 99%

Granuloma faciale: clinical, morphological and immunohistochemical aspects in a series of 10 patients

Oliveira

Ianhez²,

Marques

et al. 2016

An. Bras. Dermatol.

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“…It is seen in granuloma faciale, erythema elevatum diutinum, eosinophilic angiocentric fibrosis, inflammatory pseudotumors, and IgG4-related sclerosing diseases. [4][5][6][7][8] These conditions share a chronic slowly progressive course, resistance to medical therapy, and a dense fibroid texture. LCFV is thought to be caused by a poor clearance of antigen, but there are only a small number of cases in which a possible antigenic stimulus has been identified.…”

Section: Discussionmentioning

confidence: 99%

Localized Chronic Fibrosing Vasculitis in a Tattoo

Deeken

Jefferson

Hawkinson

et al. 2014

The American Journal of Dermatopathology

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Decorative tattoos are associated with a variety of adverse cutaneous reactions. We describe a unique fibrosing vasculitic reaction to red tattoo ink. The histopathology was similar to that in localized chronic fibrosing vasculitis (LCFV), but sharply limited to sites of red tattoo ink injection and associated with florid verrucoid epidermal hyperplasia. LCFV has been described in a broad variety of slowly progressive disorders with a firm consistency such as erythema elevatum diutinum, plasma cell granuloma, granuloma faciale, and IgG4-associated sclerosing diseases. It has been hypothesized that LCFV is the result of maladaptive immune reaction with failure to clear the causative antigen. To the best of our knowledge, this is the first case of LCFV associated with tattoo. We speculate on the implications our case holds for the pathogenesis of LCFV.

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“…Although the etiology of the disease is unknown, it is related to the deposit of immune complexes on the wall of post-capillary venules, activation of the complement cascade, and neutrophil chemotaxis, releasing lisoenzimes, collagenase, myeloperoxidase and hydrolases that induce fibrin deposits in and around the capillaries and venules. 5,6 The lesions consist mainly of persistent and symmetrical erythematous papules, plaques and nodules, mainly located on the extensor areas of the extremities. They are initially soft and erythematous purpuric, with occasional blisters and ulcers.…”

Section: Discussionmentioning

confidence: 99%

Clinical and surgical therapeutic approach in Erithema Elevatum Diutinum - case report

Zacaron

Gonçalves

Curty

et al. 2013

An. Bras. Dermatol.

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Erythema elevatum diutinum is a rare chronic cutaneous vasculitis which usually affects adults. It is characterized by symmetrical and persistent papules, plaques, and nodules. These lesions are usually located on the extensor surfaces of the extremities. We report a case of erythema elevatum diutinum in which the association of dapsone and surgical excision promoted complete remission of skin lesions, providing a new approach to the treatments described in the literature.

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Erythema elevatum diutinum - a chronic leukocytoclastic vasculitis microscopically indistinguishable from granuloma faciale?

Abstract: The histopathology of GF and EED is very similar and overlapping. The presence of a Grenz zone and patterned fibrosis does not distinguish the two diseases. However, granulomatous nodules are only seen in EED, and a predominance of eosinophils in the infiltrate favors a diagnosis of GF.

Cited by 34 publications

References 42 publications

Granuloma faciale: clinical, morphological and immunohistochemical aspects in a series of 10 patients

Granuloma faciale: clinical, morphological and immunohistochemical aspects in a series of 10 patients

Localized Chronic Fibrosing Vasculitis in a Tattoo

Clinical and surgical therapeutic approach in Erithema Elevatum Diutinum - case report

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