Annular Elastolytic Giant Cell Granuloma: An Unusual Case with Lesions Arising in Non‐sun‐exposed Areas

Abstract

A 70-year-old man with a 2-year history of annular elastolytic giant cell granuloma associated with diabetes mellitus was reported. The lesions mainly developed in non-sun-exposed areas. Histologic examination revealed phagocytosis of elastic fibers by histiocytic cells. Immunoperoxidase staining for lysozyme disclosed positive reactivity within the cytoplasm of these histiocytic cells. Electron microscopic study also showed elastic fibers and numerous lipid-like substances in the cytoplasm of these cells. These findings indicate high phagocytolytic activity by these infiltrating cells. In our case, actinic damage was not considered to be a primary causative factor, and a possible pathogenesis was also discussed.

Effective treatment with hydroxychloroquine in a case of annular elastolytic giant cell granuloma

“…[2,3] AEGCG is generally considered to be a disease mainly affecting sunexposed areas, but rarely it can also localize on covered areas. [6,7] Generalized lesions involving both sunexposed and covered areas with no history of sun exposure was an interesting finding in our case providing further evidence that photosensitivity may not be the only factor in the etiopathogenesis of AEGCG.…”

Annular Elastolytic Giant Cell Granuloma: An Unusual Case with Papular Lesions

“…Annular plaques on the face, neck, and arms with the findings of marked elastophagocytosis by giant cells and absence of elastic fibers in the dermis have been previously reported as two clinicopathological entities; O'Brien (2) reported a case of "actinic granuloma", but Hanke et al (l) used the term "annular elastolytic giant cell granuloma" (AEGCG). AEGCG tends to accompany diabetes mellitus (1,3,4), sarcoidosis (l) and generalized granuloma annulare (2), and to occur on sun-exposed areas of the body in many western countries, but to occur frequently on non-sun-exposed areas in Japan (4,5).…”

Elastolytic Actinic Giant Cell Granuloma

“…13,48 This higher incidence may be explained by the damage of elastic fibers caused by the hyperglycemia, contributing to triggering the immune response. 25,48 The percentage of patients with diabetes is even higher among patients with the necrobiotic variant of AG. 13 For this reason, DM should be ruled out in patients diagnosed with EAGCG.…”

“…12,[22][23][24][25] O'Brien 17 interpreted these variants as generalized and exaggerated reactions to a minor degree of actinic elastosis.…”