Generalized granuloma annulare in a patient with temporal arteritis-are these conditions associated?

Abstract

A case of generalized granuloma annulare associated with temporal arteritis is described. The patient, a 79-year-old man, noticed numerous asymptomatic lesions on his trunk and extremities for 3 months. Four months later, he suffered from headache and loss of vision. Both were successfully treated by oral administration of prednisolone.

Comorbidities Associated with Granuloma Annulare: A Cross-Sectional, Case-Control Study

“…However, this finding is interesting due to reports of GA occurring simultaneously with giant cell arteritis (GCA), a particular cause of headaches. These conditions have been reported to occur together, and resolve with the same medications [ 17 , 18 ]. The presence of giant cells, granulomas, vascular deposition of IgM and C3, CD4 T-cell involvement [ 17 ], and an increased expression of HLA-B15 [ 18 ] in both GA and GCA lends credence to the possibility of a shared pathophysiologic mechanism.…”

“…These conditions have been reported to occur together, and resolve with the same medications [ 17 , 18 ]. The presence of giant cells, granulomas, vascular deposition of IgM and C3, CD4 T-cell involvement [ 17 ], and an increased expression of HLA-B15 [ 18 ] in both GA and GCA lends credence to the possibility of a shared pathophysiologic mechanism. Despite the limitations of our study, it is possible that our non-migraine headache classification could have served as a proxy for a headache of a vascular origin.…”

Giant Cell Arteritis with Generalized Granuloma Annulare

“…Furthermore, the latter specimens demonstrated wall necrosis, fibrinoid changes and thickening or occlusion of blood vessels; taken together, these findings show that immunoglobulin-mediated vasculitis plays an important role in both GGA and GCA (3, 4). Corticosteroids, currently the first-line treatment for GCA (11), have been successfully used in the treatment of a patient with GGA complicated by GCA (5). Corticosteroid-sparing agents are considered for preventing the adverse effects arising from long-term exposure to glucocorticoid: for example, methotrexate is frequently used in combination with corticosteroids (11).…”

“…Taken together, these findings support the hypothesis that GCA and GGA share common etiologies. To date, there have only been four case reports of concomitant GCA and GGA (5-8) (Table). Shoimer et al diagnosed their case as annular elastolytic giant cell granuloma (AEGCG), which they considered to be different from GA (7).…”

“…GCA and GGA reportedly share common histological features (3, 4); this suggests that the two diseases might also share some etiologies. However, GCA associated with GGA appears rare, with only four reported cases (5-8). We herein describe the case of an 80-year-old man with GGA and GCA who was successfully treated with oral prednisolone (PSL).…”