By Gary M. White, MD
Persistent or recurrent sterile granulomas, both cutaneous and extracutaneous, have been reported in patients with a variety of immunodeficiencies, e.g. common variable immunodeficiency, congenital agammaglobulinemia, severe combined immunodeficiency, X-linked hypogammaglobulinemia, ataxia telangiectasia and PLAID.
Indurated, erythematous papules, nodules and plaques with central scaling, scarring, atrophy, and even ulceration in a child with immunodeficiency which on biopsy show granulomatous changes are characteristic. Systemic granulomas occur.
Referral to a specialist is in order. Infection should of course be excluded. TNF-α antagonists (etanercept and infliximab) have been used to treat granulomas in patients with common variable immunodeficiency.
Large lesions on the face. Indian Dermatol Online J 2015;6:64-5
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