Annular elastolytic giant cell granuloma of conjunctiva: A case report

Abstract

Annular elastolytic giant cell granuloma is a condition characterized histologically by damaged elastic fibers associated with preponderance of giant cells along with absence of necrobiosis, lipid, mucin, and pallisading granuloma. It usually occurs on sun-damaged skin and hence the previous name actinic granuloma. A similar process occurs on the conjunctiva. Over the past three decades only four cases of conjunctival actinic granuloma have been documented. All the previous patients were females with lesions in nasal or temporal bulbar conjunctiva varying 2-3 mm in size. We report a male patient aged 70 years presenting with a 14 mm × 7 mm fleshy mass on right lower bulbar conjunctiva. Clinical differential diagnoses were lymphoma, squamous cell carcinoma in situ and amyloidosis. Surgical excision followed by histopathology confirmed it to be a case of actinic granuloma. This is the first case of isolated conjunctival actinic granuloma of such a large size reported from India.

Infiltrated papules on the trunk and headaches: A case of actinic granuloma and a review of the literature

“…Actinic granuloma classically presents as an annular plaque, most commonly on sun-exposed areas of the head, neck, and upper extremities, with an atrophic or hypopigmented center and elevated erythematous borders. There is also an ocular variant of actinic granuloma, which has been reported to occur as a yellow to pink plaque on the conjunctiva ( Konar et al, 2014 , Mittal et al, 2013 ). Few reports have detailed an association between actinic granuloma and related inflammatory conditions.…”

Bilateral Conjunctival Actinic Granuloma With Necrobiotic Vasculitic Pattern: A Diagnosis of Exclusion

“…11,12 However, since the first description of conjunctival actinic granuloma in 1972, no such association with giant cell arteritis or other forms of autoimmune diseases has been documented in conjunctival actinic granuloma. [2][3][4][5][6][7][8][9][10] Our patient, similarly, had no symptoms or clinical findings concerning giant cell arteritis.…”

“…Subsequently, this phenomenon has been reported, albeit sparsely, to involve the eye, with the lesions most commonly manifesting as an inflamed pinguecula or nodular episcleritis. [2][3][4][5][6][7][8][9][10] Our understanding of conjunctival actinic granuloma is evolving as more diverse manifestations of this entity continue to surface. While early reports highlighted this lesion exclusively in Caucasian females, suggestive of an autoimmune cause, 2-6 more recent reports have described actinic granuloma in other ethnic groups, 7,8 and in males.…”

“…[2][3][4][5][6][7][8][9][10] Our understanding of conjunctival actinic granuloma is evolving as more diverse manifestations of this entity continue to surface. While early reports highlighted this lesion exclusively in Caucasian females, suggestive of an autoimmune cause, 2-6 more recent reports have described actinic granuloma in other ethnic groups, 7,8 and in males. 8,9 Additionally, recent reports have documented the presence of varied histomorphological patterns of conjunctival actinic granuloma, similar to those seen in the skin, including giant cell, histiocytic, and sarcoidal patterns.…”

Conjunctival Actinic Granuloma: A Clinicopathological and Immunohistochemical Study With a Review of the Literature and a Differential Diagnosis

“…Although the inescapable UV exposure to the thin transparent interpalpebral conjunctiva leads to pingueculae and pterygia, AGs are nonetheless rare in the conjunctiva. Conjunctival AGs have only been reported 8 times in the literature 10,14–18 (Table).…”