Xantoma eruptivo com aspecto histopatológico inusitado simulando granuloma anular: Relato de caso

Abstract

Resumo:Xantoma eruptivo e granuloma anular são doenças dermatológicas com quadros clínicos distintos que, algumas vezes, apresentam semelhanças histopatológicas que podem conduzir a diagnóstico errô-neo. Relata-se o caso de paciente do sexo masculino com 34 anos, portador de dislipidemia, com lesões clinicamente características de xantoma eruptivo cujo exame histopatológico foi sugestivo de granuloma anular. No entanto, a revisão da lâmina mostrou tratar-se de xantoma eruptivo. A remissão completa e ráp-ida das lesões após o tratamento da dislipidemia confirmou o diagnóstico de xantoma eruptivo e motivou a pesquisa sobre as semelhanças e diferenças histopatológicas entre essas doenças. Palavras-chave: Biópsia; Granuloma anular; Xantomatose Abstract: Eruptive xanthoma with unexpected granuloma annulare-like microscopic appearance -Case report Abstract: Eruptive xanthoma and granuloma annulare are dermatological diseases with different clinical findings that, sometimes, exhibit histopathological similarities with potential for misinterpretation. We report a case of an eruption of yellow-orange papules with erythematous borders in a 34-year-old male with high levels of serum triglycerides and cholesterol. The skin biopsy specimen has diagnosed granuloma annulare. Review of the histologic material revealed eruptive xanthoma. Remission of the eruption after treatment of dyslipidemia confirmed the diagnosis of the eruptive xanthoma and motivated research about the histological similarities and differences between these diseases.

Eruptive Xanthoma With Dermal Mucin Deposition

“…Histologically, EX can be difficult to distinguish from granuloma annulare (GA), as biopsy specimens from both conditions may exhibit histiocytes, fibrin deposition, and perivascular and interstitial lymphocytes. 1 In general, xanthoma is not accompanied by dermal mucinosis, so mucin deposition is frequently used to differentiate xanthoma from GA. Fagundes et al 2 reported a case of eruptive xanthoma, in which the histologic diagnosis was changed from GA to xanthoma after the dermatologist confirmed the clinical features. Cooper et al 3 proposed some microscopic features to distinguish EX from GA. First, EX mainly presents with perivascular histiocytes, but GA shows both perivascular and interstitial lymphocytes.…”