Interstitial granulomatous dermatitis with cutaneous cords and arthritis: A disorder associated with autoantibodies

Interstitial granulomatous dermatitis with arthritis

“…Moreover, because IGDA has never been reported with leukocytoclastic vasculitis, we believe that IGDA may not be in the same spectrum with PNGD. [5][6][7] In our case, cutaneous lesions were different from the original lesions described in the literature. We observed erythematous papules and plaques on the dorsum of the arms and legs, rather than linear bands on the trunk or axilla.…”

“…5 Histopathology of this entity is quite distinct and characterized by a diffuse dense inflammatory infiltrate, composed mostly of histiocytes within reticular dermis. Small foci of degenerated collagen and histiocytes are arranged in palisades.…”

“…Mucin deposition and vasculitis are not expected. 5 The clinical and histopathologic diagnostic considerations of IGDA mainly include granulomatous drug reactions, rheumatoid neutrophilic dermatosis, interstitial granuloma annulare, and extravascular necrotizing granuloma (Table 1).…”

Acute-Onset, Painful Acral Granuloma Annulare

“…A variety of clinical presentations, including papules, plaques, or linear cords, often with a bilateral and symmetrical distribution, have been reported under a variety of monikers, including interstitial granulomatous dermatitis with arthritis, Churg-Strauss granuloma, palisaded neutrophilic and granulomatous dermatitis, rheumatoid papule or vasculitis, and, more recently, interstitial granulomatous dermatitis with plaques. [4][5][6][7][8] All of these conditions may clinically mimic generalized GA and are to be considered manifestations of a number of immunologically mediated diseases, including, but not limited to, rheumatoid arthritis, collagen vascular disease, Wegener granulomatosis, inflammatory bowel disease, and lymphoproliferative disorders. These conditions may also mimic GA from a histologic standpoint, although the diffuse interstitial pattern often exhibits numerous eosinophils, few to absent giant cells, and scant mucin deposition, in contrast to conditions found in GA. [4][5][6][7][8] The palisaded pattern, with the formation of basophilic necrobiotic zones containing neutrophils and neutrophilic debris with variable vascular fibrin deposition (or so-called ChurgStrauss granuloma), may more closely mimic GA histologically.…”

“…[4][5][6][7][8] All of these conditions may clinically mimic generalized GA and are to be considered manifestations of a number of immunologically mediated diseases, including, but not limited to, rheumatoid arthritis, collagen vascular disease, Wegener granulomatosis, inflammatory bowel disease, and lymphoproliferative disorders. These conditions may also mimic GA from a histologic standpoint, although the diffuse interstitial pattern often exhibits numerous eosinophils, few to absent giant cells, and scant mucin deposition, in contrast to conditions found in GA. [4][5][6][7][8] The palisaded pattern, with the formation of basophilic necrobiotic zones containing neutrophils and neutrophilic debris with variable vascular fibrin deposition (or so-called ChurgStrauss granuloma), may more closely mimic GA histologically. 8 The diffuse interstitial pattern was not seen in our patients' biopsy specimens, nor did their clinical presentation reveal the intertriginous and symmetrically distributed lesions typically noted in interstitial granulomatous dermatitis and other related disorders.…”