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Generalized annular granuloma after initiation of therapy with beta
blockers for glaucoma-case report-
• * Dermatology Department, „Carol Davila” Central University Emergency Military Hospital, Bucharest
• ** Dermatopathology Department, „Domina-Sana” Medical Center, Bucharest
Andreea Stancu* , Aurel Doru Chirita**, Irina Margaritescu**
Introduction• Granuloma annulare (GA) is a benign
inflammatory dermatosis• Granuloma annulare is a relatively common
disease that occurs in all age groups• Characterized:– clinically by dermal papules and annular
plaques –histologically by foci of degenerative collagen
associated with palisaded granulomatous inflammation
Clinical case We report a case of a
59 years-old women who presented with a 3 months history of pruritic papules, patches and well circumscribed plaques
The lesions appeared first on the abdomen and anterior thorax and in a few days they became generalized
Granulomatous nodular dermatitis with superficial and deep perivascular infiltrate of lymphocytes and histiocytes arranged in a palisade around a locus that consists mostly of mucin, and degenerated collagen bundlles
Discussion
• Granuloma annulare can present with two different histologic patterns:
PalisadedInterstitialOur case have findings of both palisaded and
interstitial patterns
Conclusions• Although the aetiology and pathogenesis of
granuloma annulare are unclear, it appears likely that it represents a reaction pattern to a variety of triggering factors
• Because lesions started after the initiation of the B-blocker treatment we suspected a drug reaction
• Treatment:– discontinuation of culprit drug– Corticosteroids– PUVA-therapy