Granuloma anular subcutáneo: reporte de un caso

Abstract

ResumenIntroducción: El granuloma anular es una dermatosis inflamatoria granulomatosa de carácter benigno y autolimitado. El granuloma anular subcutáneo es una variante poco común, que se presenta casi exclusivamente en niños menores y se caracteriza por la aparición de nódulos de consistencia firme de predominio en extremidades inferiores, glúteos, manos y cuero cabelludo. Objetivo: Reportar un caso de granuloma anular subcutáneo, revisar su diagnóstico diferencial y las opciones terapéuticas actuales. Caso clínico: Paciente de sexo masculino de 4 años. Desde los 2 años y medio con nódulos subcutáneos indurados asintomáticos, inicialmente en dorso de dedo medio mano izquierda, luego en dorso de mano izquierda, primer ortejo derecho, zona frontal izquierda y cuero cabelludo. La biopsia excisional de algunas lesiones de cuero cabelludo fue compatible con granuloma anular subcutáneo. Como tratamiento se indicó clobetasol 0,05% crema 2 veces al día en lesiones por 1 mes, sin cambio en las lesiones. Conclusiones: El granuloma anular subcutáneo debe considerarse dentro del diagnóstico diferencial de nódulos subcutáneos en niños. En la mayoría de los casos se requerirá biopsia y estudio histopatológico de las lesiones para su confirmación diagnóstica. Debido a su tendencia a la resolución espontánea, generalmente se sugiere no tratar y controlar periódicamente. Keywords:Granuloma annulare, subcutaneous granuloma annulare, subcutaneous nodules Abstract Introduction: Granuloma annulare is a benign and self-limited cutaneous disease. Subcutaneous granuloma annulare is an uncommon variant seen almost exclusively in young children, characterized by firm nodules appearing more frequently in lower extremities, buttocks, hands and scalp. Objective: To report a case of subcutaneous granuloma annulare and review its differential diagnoses and treatments. Clinical case: A 4 year-old male patient. Since 2 and a half years of age he presented asymptomatic firm subcutaneous nodules on the back of the left middle finger and later on the back of the left hand, right big toe, left frontal area and scalp. Excisional biopsy of some lesions from the

Granuloma Annulare: A Rare and Unusual Lesion of the Eyelid

“…In the treatment of localized lesions, topical steroids and tacrolimus may be the first choice. Similarly, after the diagnosis is confirmed, as in our case, intralesional steroid injection can be performed [2,3,6]. However, it is crucial to remain aware of potential serious side effects that can arise after intralesional steroid injections in the periorbital region, such as central retinal artery occlusion and increased intraocular pressure.…”

“…Other differential diagnoses to consider include sarcoidosis nodules and, other tumors found in the periocular area (tricholemmoma, eosinophilic granuloma, and basal cell carcinoma) which are more commonly seen in adults. [2,3,6,8] In our case, the lesion on the upper eyelid initially appeared small and dot-like, but its wormlike appearance with topical steroid use led us to consider topical larva migrans. However, the absence of epidemiological characteristics suggestive of larva migrans, the normal blood This article is protected by copyright.…”

“…[2] The literature has noted that it may be caused by insect bites, trauma, intradermal skin tests, various viral agents (Epstein-Barr virus and the Herpes simplex virus), and tuberculosis. [2,3] Subcutaneous granuloma annulare is most common in children and young adults. The lesions consist of non-inflamed appearance, painless subcutaneous nodules on the skin's surface.…”

“…In our case, blood tests were normal, and no known comorbidities were present. Other differential diagnoses to consider include sarcoidosis nodules and other tumors found in the periocular area (trichilemmoma, eosinophilic granuloma, and basal cell carcinoma), which are more commonly seen in adults 2 , 3 , 6 , 8 .…”

“…Similarly, after the diagnosis is confirmed, as in our case, intralesional steroid injection can be performed. [2,3,6] However, it is crucial to remain aware of potential serious side effects, that can arise after intralesional steroid injections in the periorbital region, such as central retinal artery occlusion and increased intraocular pressure. It is essential to provide patients with through information regarding these risks, ensure close monitoring during and after treatment.…”