Vasculitis with granulomatosis: An atypical presentation of giant cell arteritis

Sarcoidal Granuloma Annulare–Like Dermatitis and Vasculitis With Granulomatous Features: An Atypical Case of Giant Cell Arteritis

“…[6][7][8][9] Neurologic symptoms of GCA occurred within 1 month up to 1 year from the cutaneous eruptions, raising the possibility that it may be a harbinger of impending disease. 5 Similarly, in our patient, the cutaneous findings presented 4 months before the headache and vision loss, suggesting the cutaneous involvement as potential precursors to GCA development.…”

“…16 The 2 cutaneous manifestations in our patient have each been described and associated with GCA independently, but not together. They have also been shown to share similar immunologic and histologic features of GCA, particularly GA. [5][6][7][8][9] Our case highlights the co-occurrence of these 2 cutaneous features before the neurologic symptoms of GCA. Although the notion that these 2 cutaneous manifestations as coincidental occurrences cannot be dismissed, a true association with GCA should be considered as both cutaneous morphologies resolved without recurrence, and both share common pathologic features of granulomatous inflammation found in GCA.…”

“…4,15 Of those found in the literature, 4 cases reported generalized GA in association with GCA, and 1 reported vasculitis with granulomatosis on histopathology, similar to our patient. [4][5][6][7][8][9] All 4 cases reported generalized GA, and in 3 of the 4 cases, GA preceded the classic symptoms of GCA. [6][7][8][9] Neurologic symptoms of GCA occurred within 1 month up to 1 year from the cutaneous eruptions, raising the possibility that it may be a harbinger of impending disease.…”

“…3,4 Other cutaneous manifestations including granuloma annulare (GA) and vasculitis with granulomatosis have been described in association with GCA. [5][6][7][8][9] We present an atypical case of GCA with the co-occurrence of 2 distinct cutaneous morphologies preceding the classic neurologic symptoms.…”