Subcutaneous granuloma annulare following influenza vaccination in a patient with diabetes mellitus

Suzuki, Takahiro; Shimauchi, Takatoshi; Moriki, Mutsumi; Tokura, Y.

doi:10.1016/j.dsi.2013.03.004

Cited by 6 publications

(6 citation statements)

References 10 publications

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“…Granuloma annulare (GA) is a non-infectious granulomatous skin reaction with potential triggers that can affect adult and pediatric populations. The etiology of GA is unknown, but medication, infection, trauma, insect bites, and vaccination have been reported as triggering factors [1][2][3]. Solitary, erythematous, annular papules, and plaques are found predominantly in the acral regions.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Histopathological Evaluation of Forty-one Cases of Pediatric Granuloma Annulare

Aksu¹,

Erdil²,

Baş³

et al. 2023

Dermatol Pract Concept

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Introduction: Granuloma annulare (GA) is a non-infectious granulomatous disease that can affect children and adults. Although many studies have been conducted adult GA patients, the literature on pediatric GA cases is limited. Objectives: Therefore, this study aimed to examine the demographic, clinical, and pathological features of pediatric GA cases. Methods: This study was performed retrospectively in a single-center tertiary dermatology hospital. Demographic characteristics and clinical and histopathological features were recorded. Results: Forty-one participants were included in this study, of which 66% were female. The mean age was 3.8 ± 2.6 years, and the mean lesion duration was 7.5 ± 10.3 months. The involvement of 78% of the patients was localized, and the remaining 22% was generalized. Asthma (30%) was the most common comorbid disease. Histopathological examination was performed on twenty-one patients, and the infiltrate pattern was interstitial in 71% of the cases and palisadic in 29%. Generalized distribution, trunk involvement, and concomitant disease tended to be higher in patients with an interstitial pattern than in those with a palisadic pattern. Conclusions: Atopy and asthma should be questioned in pediatric GA cases. There are differences between involvement, distribution, concomitant disease, and histopathological patterns, which may indicate differences in pathogenesis.

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Section: Introductionmentioning

confidence: 99%

Clinical and Histopathological Evaluation of Forty-one Cases of Pediatric Granuloma Annulare

Aksu¹,

Erdil²,

Baş³

et al. 2023

Dermatol Pract Concept

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“…The bacillus Calmette-Guérin (BCG) vaccine has been most frequently reported to be causative vaccine (eight cases), followed by the hepatitis B vaccine (HBV; two cases) and the influenza, tetanus and diphtheria–tetanus toxoid vaccines (one case each). 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 An association between the pneumococcal vaccine and GA has not been previously described ( Table 1 ).…”

Section: Discussionmentioning

confidence: 96%

“…The traumatic inoculation hypothesis is less convincing, because GA exclusively located at the vaccination site has been observed in few cases. 6 , 9 …”

Section: Discussionmentioning

confidence: 99%

Generalized granuloma annulare after pneumococcal vaccination

García‐Gil

Álvarez‐Salafranca

García

et al. 2021

Anais Brasileiros de Dermatologia

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“…However, GA has been associated with diabetes, thyroid disease hyperlipidemia, infections, and mild trauma [ 3 , 5 ]. Other reported potential triggers could be related to drug eruptions, an infection, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other viral infections, subcutaneous injections for desensitization, vaccinations against hepatitis B, Bacillus Calmette-Guerin (BCG), human papilloma virus, diphtheria, and tetanus [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis of GA can sometimes be made on the basis of the classic clinical features of GA. In cases that are harder to diagnose, a correlation between the clinical findings and histologic findings are necessary [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Granuloma annulare and possible relation to purified protein derivative administration: a case report

Lee,

Steffen,

Carroz

et al. 2024

J Med Case Reports

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Background Granuloma annulare is a noninfectious inflammatory granulomatous skin disease characterized by an erythematous or skin colored annulare plaque. The diagnosis of granuloma annulare may be challenging owing to its diverse morphology. In such cases, a correlation between the clinical findings and histologic findings are necessary. Case presentation We report a case of granuloma annulare after purified protein derivative administration. A 56-year-old Caucasian female patient complained of mildly pruritic rashes which started on both arms and lower extremities, and eventually spread to both thighs, the left popliteal region, left upper back, and the right abdominal area. About 6 weeks prior to the eruption of the rashes, the patient had been given a purified protein derivative tuberculin skin test. Biopsy specimens revealed dermal histiocytes palisading around areas of mucin and degenerated collagen, confirming granuloma annulare. After treatment with 0.1% topical triamcinolone acetanide and 500 mg oral metronidazole, the patient’s lesions resolved. Discussion Relatively little is known about granuloma annulare’s exact etiology. Granuloma annulare has four variations presenting as either localized, generalized, subcutaneous, or perforating and patch granuloma annulare. The clinical prognosis for granuloma annulare varies according to clinical subtypes. Proposed causal mechanisms of subcutaneous granuloma annulare include physical trauma, infections, immunizations, insect bites, diabetes mellitus, and alterations in the cell-mediated immune responses. The disease likely has an inflammatory component. Clinically, granuloma annulare may be confused with many other skin diseases. Conclusion This case of subcutaneous granuloma annulare was reported since it is a rare dermatologic pathological condition that can be confused with other skin rash disorders. Although it is a benign self-limited disease, definitive diagnosis is important to rule out other pathologies with similar clinical appearances, such as cancer or human immunodeficiency virus (HIV) infection. Diagnostic confirmation is best made through skin biopsy.

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Subcutaneous granuloma annulare following influenza vaccination in a patient with diabetes mellitus

Cited by 6 publications

References 10 publications

Clinical and Histopathological Evaluation of Forty-one Cases of Pediatric Granuloma Annulare

Clinical and Histopathological Evaluation of Forty-one Cases of Pediatric Granuloma Annulare

Generalized granuloma annulare after pneumococcal vaccination

Granuloma annulare and possible relation to purified protein derivative administration: a case report

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