Generalised papular variant of elastolytic giant cell granuloma

Abstract

Elastolytic giant cell granuloma (EGCG), also known as actinic granuloma, is an uncommon granulomatous dermatosis usually characterised by asymptomatic annular plaques on sun-exposed skin. Its aetiology is not fully elucidated, but actinic damage has been considered the main causal factor. Atypical variants with lesions in a non-photodistributed pattern are rare and often related to a systemic disorder, suggesting a more complex pathogenesis and demanding for a screening work-up. Herein, we report a case of an adult obese, diabetic woman presenting with a generalised pruritic papular eruption, histologically revealing an elastolytic giant cell granuloma, with a good response to treatment. In this case, the dermatosis was probably associated with her metabolic comorbidities.

A Retrospective Study of 105 Patients with Elastolytic Giant Cell Granuloma and a Proposal for a New Clinical Classification

“…Patients should be instructed to rigorously protect their skin from sun. Treatment is based on limited case reports and series, reported treatments including topical, intralesional and systemic glucocorticoids, topical calcineurin inhibitors, methotrexate, hydroxychloroquine, minocycline, acitretin, dapsone, cyclosporine, ciclosporin, clofazimine, cryotherapy, psoralen ultraviolet A and narrow-band ultraviolet B therapy ( 2 – 4 , 6 , 9 , 11 , 12 , 22 – 24 ). The effectiveness of these treatment is variable.…”

“…Annular elastolytic giant cell granuloma (AEGCG), an idiopathic type of granulomatous dermatosis, is characterized clinically by annular lesions that expand centrifugally on sun-exposed areas ( 1 ). Recently, many atypical variants of this condition, including papular ( 2 ), reticular ( 3 ), generalized forms ( 4 ), concomitant conditions ( 5 ) and lesions involving sun-protected areas had been reported. Despite the various clinical presentations, AEGCG is characterized histopathologically by elastolysis, elastophagocytosis, and an infiltrate of multinucleated giant cells.…”

“…Given that lesions of this condition are not always annular and not always in sun-exposed areas, the previous terms “actinic granuloma” (AG) and “AEGCG” seem inappropriate. The terms “giant cell elastolytic granuloma” and “elastolytic giant cell granuloma” (EGCG) have been proposed in the previous studies to define this condition ( 4 , 9 ).…”

Light‐ and laser‐based treatments for granuloma annulare: A systematic review

“…73 Additionally, GA has many physical similarities with annular elastolytic giant cell granuloma (AEDCG), a rare and often self-limiting chronic inflammatory disorder which occurs mainly on sun exposed areas. 75,76 A skin biopsy showing the absence of palisading histiocytes, necrobiosis, and mucin deposition distinguishes the diagnosis of AEGCG from GA. 77,78 Authors stress the importance of ruling out AEDCG, as light may worsen these lesions.…”

Papular interstitial elastolytic giant cell granuloma concomitant with lichen amyloidosus in a type II diabetes patient

“…Elastolytic giant cell granuloma (EGCG) is an idiopathic granulomatous disease with various clinical features 1 . Of them, the papular EGCG is a rare variant, and it is occasionally associated with metabolic comorbidities 2 and haematological disorders 3,4 . Indeed, the ratio of papular variant of EGCG is about 15% among EGCG 1 .…”