Annular elastolytic giant cell granuloma in association with Hashimoto's thyroiditis

Abstract

Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous skin disease characterized clinically by annular plaques with elevated borders and atrophic centers found mainly on sun-exposed skin and histologically by diffuse granulomatous infiltrates composed of multinucleated giant cells, histiocytes and lymphocytes in the dermis along with phagocytosis of elastic fibers by multinucleated giant cells. We report a case of AEGCG in a 50-year-old woman and is highlighted for the classical clinical and histological findings of the disease and its rare co-existence with Hashimoto's thyroiditis.

Can Methotrexate be a successful treatment for unresponsive generalized annular elastolytic giant cell granuloma? Case report and review of the literature

“…In the literature a total of 10 articles, limited to individual case reports and letters published from 1991 to 2017 about generalized AEGCG, were identified (Table 1). [8][9][10][11][12][13][14][15][16][17] It emerges that generalized AEGCG, associated to a specific cause, was successfully treated with targeted therapy aimed at resolving the causative Koebner effect. For instance, AEGCG associated to Borrelia burgdorferi infection, was successfully treated with doxycycline.…”

“…Hashimoto's thyroiditis completely regressed after thyroid surgery. 10 On the contrary, in cases where no specific causative Koebner effect could be identified, further therapies such as minocycline hydrochloride, chloroquine, hydroxychloroquine and tranilast, associated to topical or oral steroids, were used with partial benefit (Table 1).…”

Annular Elastolytic Giant Cell Granuloma

“…The most commonly reported risk factor is intense sun exposure/tanning beds and is more commonly seen in fair-skinned individuals [ 15 ] residing in a sunny climate. Other possible predisposing conditions and associations include diabetes mellitus (DM), sarcoidosis [ 7 ], giant cell arteritis [ 5 ], polymyalgia rheumatica, polychondritis, vitiligo [ 3 , 9 ], anemia, leukopenia, hepatitis C, focal segmental glomerulosclerosis, Hashimoto's thyroiditis [ 16 ], erythema nodosum [ 17 ] and protoporphyria [ 18 ]. A list of possible differentials for our patient included photodermatoses (lack of suggestive histopathologic findings in this patient rules it out), granuloma annulare, necrobiosis (lack of evidence of DM), drug-induced photosensitivity (lack of consumption of associated medications), dermal manifestations of auto-immune disorders, such as systemic lupus erythematosus (negative ANA titer).…”

Annular Plaques Overlying Hyperpigmented Telangiectatic Patches on the Neck

“…[1][2][3][4] Histologically, AEGCG is characterized by diffuse granulomatous infiltrates composed of multinucleated giant cells, histiocytes, and lymphocytes in the dermis, along with phagocytosis of elastic fibers by multinucleated giant cells. 5 The underlying etiology and pathogenesis of AEGCG remains unknown. 6 Annular elastolytic giant cell granuloma commonly affects females aged 35 to 75 years; however, cases have been reported in the male and pediatric patient populations.…”