Interstitial granulomatous dermatitis in a child with chronic uveitis

Interstitial Granulomatous Dermatitis

“…They have been described in the setting of RA, 14 juvenile idiopathic arthritis, 15 SLE, 16 ulcerative colitis, 17 vasculitis, 18 chronic uveitis 19 and lymphoproliferative diseases, 20 conditions believed to induce maintained production of immune reactants.…”

Reactive Granulomatous Dermatitis

“…42 Similar to PNGD, there is a 3:1 female to male predominance, 38 again likely owing to the association with underlying autoimmune diseases. The initial description of IGD was that of linear subcutaneous cords or bands on the proximal trunk, 32 although over time the clinical morphologic spectrum has expanded and many feel that other presentations are in fact more common with cords reported in less than 10% of cases.…”

“…As such, reported treatments include aggressive systemic agents geared toward controlling the IGD-associated systemic disease, which may also clear the IGD (systemic steroids, 38 etanercept, 38,47 methotrexate, 36,38 cyclosporine, 46 intravenous immunoglobulin, 71 tocilizumab, 72 and ustekinumab 50 ). There are reports of improvement with topical steroids, 38,42,46 nonsteroidal antiinflammatory drugs, 46,73 systemic corticosteroids, 43,46 dapsone, and hydroxychloroquine. 46 Infliximab was used for a recalcitrant case.…”

Ackerman syndrome: a rare cause of arthritis with dermatitis

“…The associated conditions, for example, SLE or rheumatoid arthritis, could have a significant role in influencing the choice of agents. Treatment options include non-steroidal anti-inflammatory drugs,14 topical steroids,13 15 systemic steroids6 16 17 or any combination of these agents 8 18. Other available options for more resistant cases include methotrexate,19 anti-TNF agents,20 21 toclizumab,22 ustekinumab23 and IVIG 24.…”