ANNULAR ELASTOLYTIC GIANT CELL GRANULOMA
By Gary M. White, MD
Annular elastolytic giant cell granuloma (AEGCG) is a rare condition seems to stem from an immune attack on elastic fibers. Annular papules and plaques with central clearing in photo exposed areas is typical.
- The histology is critical and should show fragmentation of elastic fibers, presence of scanty elastic fibers in the areas of the granulomatous infiltrate, and elastophagocytosis by giant cells.
- Histologic features that help distinguish AEGCG from granuloma annulare are complete loss of elastic tissue in the central zone, the absence of mucin, and the absence of collagen necrobiosis.
- For a related condition, see actinic granuloma.
- The association of AEGCG and temporal arteritis has rarely been reported. Temporal arteries seem to have an inflammatory response analogous to that seen in AEGCG involving a granulomatous reaction to damaged elastin fibers.
Annular papules and plaques with central clearing in photo exposed areas is typical.
Topical and intralesional steroids, topical tacrolimus and pimecrolimus, hydroxychloroquine, isotretinoin, dapsone, cyclosporine, and PUVA therapy have all been tried.
Adalimumab nearly cleared one patient after 12 weeks [J Drugs Dermatol 2017;16;169].
Dermatology Online Journal 16 (3): 11
Dermatology Online Journal 21(4)
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