Generalized granuloma annulare after bacillus <scp>C</scp>almette–<scp>G</scp>uérin vaccination, clinically resembling papular tuberculid

Yoon, Na Young; Lee, Noo Ri; Choi, Eung Ho

doi:10.1111/1346-8138.12293

Cited by 11 publications

(8 citation statements)

References 9 publications

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“…Although several hypotheses have been proposed to explain the etiopathogenesis of GA, the exact cause of the disease is not yet recognized. Many precipitating factors such as subcutaneous injection for desensitization,18 Octopus bite,19 bacillus Calmette–Guérin vaccination,15 mesotherapy20 and ultraviolet light exposure21 have been reported but never confirmed by controlled studies. Recent studies have pointed to a delayed-type hypersensitivity reaction to an unknown antigen as the probable mechanism underlying the development of GA lesions 22,23…”

Section: Discussionmentioning

confidence: 99%

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Granuloma annulare: relationship to diabetes mellitus, thyroid disorders and tuberculin skin test

Alirezaei

Farshchian

2017

CCID

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BackgroundGranuloma annulare is a benign inflammatory disease of the skin. The etiology and pathogenesis of the disease are not yet determined, but some authors have proposed that it might be associated with a variety of underlying conditions such as thyroid disorders, diabetes mellitus and positive tuberculin skin test.ObjectiveThis study was conducted to find the probable relationship between granuloma annulare and diabetes mellitus, thyroid disorders and positive tuberculin skin test.Patients and methodsA total of 28 patients with granuloma annulare were recruited from our dermatology outpatient clinic, and data on sex, age and distribution of granuloma annulare lesions were collected. Forty-one age- and sex-matched apparently healthy volunteers serving as controls were also included. Thyroid stimulating hormone (TSH), fasting blood sugar (FBS) and tuberculin skin tests were performed for both groups.ResultsMean serum level of FBS in the patient group was significantly higher than the mean serum level of FBS in the control group (110.60±46.31 mg/dL versus 88.39±10.58 mg/dL, respectively, p=0.004). Mean serum level of TSH in the patient group was 3.43±2.73 mIU/L, which was not significantly different from the mean serum level of TSH in the control group (3.26±2.11 mIU/L, p=0.772). Four individuals in the patient group and only 1 in the control group had a positive tuberculin skin test.ConclusionGranuloma annulare patients are better to be assessed for diabetes mellitus, but the relationship between this skin disease and thyroid disorders or tuberculin skin test still needs to be investigated.

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Section: Discussionmentioning

confidence: 99%

“…There are also reports suggesting the appearance of GA following bacillus Calmette–Guérin vaccination 15,16. Although several underlying conditions have been linked to GA, little data from controlled studies are available to validate these associations.…”

Section: Introductionmentioning

confidence: 99%

Granuloma annulare: relationship to diabetes mellitus, thyroid disorders and tuberculin skin test

Alirezaei

Farshchian

2017

CCID

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“…There are many clinical variants of the disease, including localized, generalized annular, disseminated papular, atypical generalized, subcutaneous and perforating . Generalized variants of granuloma annulare, such as generalized annular, disseminated papular and atypical generalized granuloma annulare, have been reported to be associated with systemic diseases such as diabetes mellitus, malignancy, thyroid disease, lipid abnormalities, rheumatoid arthritis and viral infections . Granuloma annulare has also been reported to develop at sites of resolved herpes zoster .…”

Section: Granuloma Annularementioning

confidence: 99%

“…[29][30][31] Generalized variants of granuloma annulare, such as generalized annular, disseminated papular and atypical generalized granuloma annulare, have been reported to be associated with systemic diseases such as diabetes mellitus, malignancy, thyroid disease, lipid abnormalities, rheumatoid arthritis and viral infections. [32][33][34][35][36][37] Granuloma annulare has also been reported to develop at sites of resolved herpes zoster. 38,39 In addition to these diseases, granuloma annulare induced by drugs such as allopurinol, pegylated IFN-a, topiramate and TNF-a inhibitors (infliximab, adalimumab and etanercept) has also been reported previously.…”

Section: Granuloma Annularementioning

confidence: 99%

What is new in the histogenesis of granulomatous skin diseases?

Asai

2017

The Journal of Dermatology

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A granuloma is a form of inflammation, which predominantly consists of macrophages. It typically develops when the immune system attempts to enclose substances that are usually insoluble and cannot be eliminated to prevent the spread of these substances to the other body compartments. According to the source of the substances, granulomatous diseases can be divided into two groups: infectious and non-infectious. The mechanisms of infectious granuloma formation have been widely investigated because of its easy reproducibility in experimental models, both in vivo and in vitro. On the contrary, mechanisms of non-infectious granuloma formation have not been well investigated because of the difficulty to reproduce this formation in experimental models. In this article, we review our recent understanding of the histogenesis and pathogenesis of granuloma formation, confirmed from studies of infectious granulomas, and we present potential hypotheses of the histogenesis and pathogenesis of non-infectious granulomas based on clinical investigations.

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“…Skin biopsy with Ziehl-Neelsen staining and immunohistochemistry is useful for ruling out these conditions, especially if the skin lesions persist for months. Of note, granuloma annulare has been reported to clinically mimic papular tuberculid, which is characterized by palisading granuloma and necrobiosis (5,6). However, rather rapid improvement does not fit the typical course of granuloma annulare in these cases, and they should be considered as a variant of papular tuberculid.…”

Section: Diagnosis: Papular Tuberculid Following Bcg Vaccinationmentioning

confidence: 97%