Interstitial granulomatous dermatitis associated with systemic lupus erythematosus: case report and review of the literature

Jandali, Bochra; Uthman, Imad; Abbas, Ossama

doi:10.1177/0961203315604908

Cited by 10 publications

(8 citation statements)

References 38 publications

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“…2 Besides arthritis and inflammatory bowel disease, systemic lupus erythematosus, systemic sclerosis, ANCA vasculitis, Sjogren's syndrome, and mixed cryoglobulinemia have also been described with RGD. [1][2][3][8][9][10][11][12][13] Analogous to previous publications, TNF inhibitors could be a trigger for RGD. 14 Out of the 10 patients in our study, 2 cases were possibly related to this medication.…”

Section: Discussionmentioning

confidence: 80%

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Reactive Granulomatous Dermatitis: A Descriptive Study of 10 Patients

Lagacé,

Mainville,

Dionne

2024

J Cutan Med Surg

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Background: Reactive granulomatous dermatitis (RGD) is a rare and misunderstood skin disorder. It includes interstitial granulomatous dermatitis and palisaded neutrophilic and granulomatous dermatitis: 2 entities of the same spectrum. Multiple associations are described with RGD in the literature, including autoimmune diseases, malignancy, and drugs. Objective: To report and describe the suspected associations with RGD at the time of diagnosis and in the following year. Methods: We retrieved and described cases of RGD confirmed by skin biopsy and clinicopathologic correlation. All patients were evaluated in the Centre Hospitalier Universitaire de Québec— Université Laval between January 2000 and December 2020. Collected data include the systemic diseases (autoimmune disease, malignancy) and suspected drugs, in addition to the clinical presentation and prescribed treatments. Results: Out of the 10 patients with RGD, 7 patients were known to have an autoimmune disease at the time of diagnosis. They either had inflammatory arthritis (3/10) or inflammatory bowel disease (4/10). There was a clinical suspicion of a possible association with a tumor necrosis factor (TNF) inhibitor in 2 of these 7 patients. Among the 3 patients with idiopathic RGD at the time of diagnosis, 1 patient developed a high-grade B-cell lymphoma 6 months later. There was no new association identified in the following year for patients with a known autoimmune condition. Conclusion: This descriptive study supports RGD and its previously described systemic associations, particularly autoimmune diseases, malignancy, and certain drugs (specifically TNF inhibitors). The majority of patients already had one of these associations identified at the time of histopathological diagnosis.

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Section: Discussionmentioning

confidence: 80%

“… 2 Besides arthritis and inflammatory bowel disease, systemic lupus erythematosus, systemic sclerosis, ANCA vasculitis, Sjogren’s syndrome, and mixed cryoglobulinemia have also been described with RGD. 1 - 3 , 8 - 13 …”

Section: Discussionmentioning

confidence: 99%

Reactive Granulomatous Dermatitis: A Descriptive Study of 10 Patients

Lagacé,

Mainville,

Dionne

2024

J Cutan Med Surg

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“…In our series, the patient with PNGD was accompanied by autoimmune hepatitis. In literature, other diseases which may accompany were autoimmune disorders such as; rheumatoid arthritis [ 3 , 4 ], systemic lupus erythematosus [ 1 , 3 , 4 , 16 ], autoimmune thyroiditis, primary biliary cirrhosis [ 7 ], malignancies such as hematological or solid cancers [ 14 , 15 ], infections such as HCV and related cryoglobulinemia [ 10 ], coccidiomycosis [ 17 ] or medications [ 4 , 5 ]. In 31.2% of patients, there were no associated autoimmunity or malignancy despite of clinical and laboratory evaluation for an underlying disorder.…”

Section: Discussionmentioning

confidence: 99%

Interstitial Granulomatous Dermatitis and Palisaded Neutrophilic Granulomatous Dermatitis: Retrospective Clinicopathological Analysis of 16 cases

Sarıkaya Tellal,

İlhan Erdil,

Gore Karaali

et al. 2023

Dermatol Pract Concept

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Introduction: Reactive granulomatous dermatitis (RGD) is a new entity, which is highly associated with systemic disorders. There is scarce data regarding interstitial granulomatous dermatitis (IGD) and palisaded neutrophilic granulomatous dermatitis (PNGD). Objectives: We aimed to evaluate clinical and histopathological characteristics of IGD and PNGD as unified entities under the term of RGD. Methods: Observational, retrospective, single-center study of patients diagnosed with IGD and PNGD between 2012 and 2021 were included in the study. Results: Of 16 patients with RGD 13 had IGD and 3 had PNGD (14 females, 2 males) with a mean age of 62,5. The most common presentation was plaques 37,5% (n=6), followed by patches 25%. The most common localization of involvement was lower extremity 75%, followed by trunk and upper extremity. Multiple localization of involvement was determined in 75% of patients. None of the patients had rope sign. Associated comorbidities such as autoimmune diseases and malignancies were detected in 68,7% of patients. In majority of biopsies (85,7%), there were lymphohistiocytic cell infiltration. Other accompanying cells were scarce neutrophils 31,2% and eosinophils 31,2%. All of the biopsies had interstitially located lymphohistiocytic cell infiltration surrounding with swollen and degenerated collagen. Palisaded pattern was determined in 18,7% of patients and floating sign was seen in 18,7% of biopsies. Conclusions: RGD is a rare entity and most patients with RGD had associated disorders such as autoimmunity or malignancy. There is overlapping between IGD and PNGD, therefore supporting the usage of umbrella term as reactive granulomatous dermatitis is compatible with the literature.

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“…Clinically, it presents with asymptomatic papules and plaques, varying in colour from skin-coloured to erythematous and frequently located in lateral upper trunk, axillae, and proximal upper limbs. Linear, cord-like nodular lesion called "the rope sign" is considered a characteristic manifestation of IGD, despite the low frequency; in fact, it occurs in 9-10% of the cases [11][12][13][14]. Histology shows scattered dermal histiocytes among and around foci of degenerated collagen, often rimming altered collagen fibers which may be "floating" ("floating sign"), while usually no vasculitis or mucin are detected.…”

Section: Introductionmentioning

confidence: 99%

Granulomatous Dermatitis and Systemic Disease: An Association to Consider

Corrà

Quintarelli

Verdelli

et al. 2021

Highlights on Medicine and Medical Research Vol. 8

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Granuloma annulare (GA) and interstitial granulomatous dermatitis (IGD) are granulomatous dermatoses with variable clinical appearances. GA is associated with diabetes mellitus, metabolic syndrome, chronic infections, and malignancies, while two Japanese reports described unusual cases of interstitial-type GA in setting of Sjogren syndrome. IGD was associated with rheumatoid arthritis, systemic lupus erythematosus, and autoantibodies. We report a case series of six patients with GA or IGD. Half of the patients were diagnosed with Sjogren syndrome, while all of them presented ANA positivity and the majority reported arthralgia. In many cases, GA showed interstitial-type histology, arising challenges in differential diagnosis with IGD. The overlap of clinical and histological features of GA and IGD can be explained considering them as a broad disease spectrum, including also the other forms of reactive granulomatous dermatitis. These conditions should be considered as an indicator of possible systemic disorders or other immunological dyscrasias, for which patients must be screened. Sjogren syndrome may be associated to GA also in Caucasians.

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Interstitial granulomatous dermatitis associated with systemic lupus erythematosus: case report and review of the literature

Cited by 10 publications

References 38 publications

Reactive Granulomatous Dermatitis: A Descriptive Study of 10 Patients

Reactive Granulomatous Dermatitis: A Descriptive Study of 10 Patients

Interstitial Granulomatous Dermatitis and Palisaded Neutrophilic Granulomatous Dermatitis: Retrospective Clinicopathological Analysis of 16 cases

Granulomatous Dermatitis and Systemic Disease: An Association to Consider

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