IADVL
Indexed with PubMed and Science Citation Index (E) 
 
Users online: 3755 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
  Search
 
   Next article
   Previous article 
   Table of Contents
  
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
   [PDF Not available] *
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article
   Abstract
   Introduction
   Case Report
   Comments
   References
   Article Figures

 Article Access Statistics
    Viewed3682    
    Printed168    
    Emailed0    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal

 


 
CASE REPORT
Year : 1994  |  Volume : 60  |  Issue : 3  |  Page : 168-169

Perforating granuloma annulare




Correspondence Address:
R R Mittal


Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

  Abstract 

Perforating Granuloma annulare (GA) of palmar surfaces of both index fingers was observed in a 41 years female. Duration was 1½ years and papules were asymptomatic, yellow, firm, discrete, with central pits. FBS was 81 mg/dl. Histopathology revealed transepidermal elimination of altered collagen, foci of degenerated collagen surrounded by groups of mononuclears admixed with occassional eosinophil and giant cell in irregular palisade arrangement.


Keywords: Granuloma, Perforating, Transepidermal elimination of collagen


How to cite this article:
Mittal R R, Chopra A K, Walia R, Dutt R, Gill S. Perforating granuloma annulare. Indian J Dermatol Venereol Leprol 1994;60:168-9

How to cite this URL:
Mittal R R, Chopra A K, Walia R, Dutt R, Gill S. Perforating granuloma annulare. Indian J Dermatol Venereol Leprol [serial online] 1994 [cited 2019 Oct 17];60:168-9. Available from: http://www.ijdvl.com/text.asp?1994/60/3/168/4030



  Introduction Top


GA can present in localised form, generalised or widely diseminated form, as subcutaneous nodules and perforating papules. [1] Perforating GA may heal with hypo or hyperpigmented scars; [2] In perforating GA umbilicated papules over the hands develop a yellowish centre due to transepidermal elimination of altered dermal collagen. [3] Generalised perforating GA has been reported. [4] Histopathologically perforating GA show transepidermal elimination of degenerated collagen, small to large foci of collagen degeneration with mucin at places, surrounded by histiocytes in palisade arrangement, vasculitis, lymphoid cells, occasional giant cells and fibroblasts. [5]


  Case Report Top


A 41-years-old female had multiple, asymptomatic, progressive, firm, well defined, flat papules and plaques on palmar surface of both index fingers since 1 [1]/2 years [Figure - 1]. Old papules resolved spontaneously after 3-4 months while new ones appeared. Papules and plaques had central depression where skin surface was rough, although retaining intact dermatoglyphic pattern of ridges alternating with depression. FBS was 81 mg/dl. Histopathology revealed hyperkeratosis and multiple channels in epidermis through which degenerated collagen was extruded [Figure - 2] Dermis showed foci of degenerated collagen surrounded by mononuclears, eosinophils and giant cells in irregular palisade arrangement [Figure - 3].


  Comments Top


Perforating GA, a rare variant of GA, may be present along sides of fingers, [5] and this was seen in the present case. Clinically. porokeratosis of Mibelli was excluded as well defined margin did not show groove. Verruca­vulgaris was ruled out histopathologically and clinically. Molluscum-contagiosum was easily differentiated as papules were bigger and central pits rather than punctum were seen. This is perhaps the first case of perforating GA in Indian literature.

 
  References Top

1.Cunliffe WJ . Necrobiotic Disorders. In Textbook of Dermatology (Champion R H, Burton J L, Ebling FJG, eds), 5th edn. London : Blackwell Scientific Publishers, 1992; 2027 - 33.  Back to cited text no. 1    
2.Delaney T J, Gold SC, Leppard B. Disseminated perforating granuloma annulare. Brit J Dermatol 1973; 89 : 523-6.  Back to cited text no. 2    
3.Owens D W, Freeman R G. Perforating granuloma annulare. Arch Dermatol 1971; 103: 64-7.  Back to cited text no. 3    
4.Hazelrigg DE. Generalized perforating granuloma annulare. A case report and review of literature. Cutis 1979; 23: 813-4.  Back to cited text no. 4  [PUBMED]  
5.Dahl MV, Ullman S, Croltz RW. Vasculitis in granuloma annulare. Arch Dermatol 1977; 113: 463-7.  Back to cited text no. 5    


    Figures

[Figure - 1], [Figure - 2], [Figure - 3]



 

Top
Print this article  Email this article
Previous article Next article

    

Online since 15th March '04
Published by Wolters Kluwer - Medknow