54 Questions
Which age group is granuloma annulare rare in?
Infancy
In which age group does the generalized or disseminated variant of granuloma annulare occur more commonly?
Middle-aged adults
What has research found about the gender preponderance in granuloma annulare?
Varied findings, with some studies reporting female preponderance and others finding higher frequency in males
Are cases of granuloma annulare typically sporadic or familial?
Sporadic
Which form of granuloma annulare occurs more frequently in children and young adults?
Localized annular form
Where on the body are the sites of predilection for granuloma annulare lesions?
Dorsal hands, feet, ankles, lower limbs, and wrists
What is the typical diameter range of the annular or arcuate lesions in granuloma annulare?
1 to 5 cm
Which color(s) may the annular or arcuate lesions in granuloma annulare be?
Skin colored, erythematous, or violaceous
What is the texture of the annular margin in granuloma annulare?
Firm to palpation
What is the most common morphology of generalized granuloma annulare?
Widespread papules
Which age group is the generalized form of granuloma annulare said to comprise 8% to 15% of cases?
Adults
What is the most common form of granuloma annulare?
Localized with annular lesions
What characterizes the subcutaneous form of granuloma annulare?
Firm to hard, usually asymptomatic nodules located in the deep dermis and subcutaneous tissues
Where are the nodules of subcutaneous granuloma annulare most commonly located?
Anterior lower legs
What is the characteristic feature of the perforating type of granuloma annulare?
Central umbilication
Where is the generalized form of granuloma annulare most commonly found?
Trunk and extremities
What is a rare variant of granuloma annulare characterized by transepidermal elimination of necrobiotic collagen?
Perforating type of granuloma annulare
What is a common complaint of patients with the perforating type of granuloma annulare?
Pruritus and pain
What is a reported characteristic of macular lesions in granuloma annulare in adult women?
Erythematous, redbrown, or violaceous patches without an annular rim
What is the observed feature alongside macular lesions in granuloma annulare?
Arcuate dermal erythema
Where are the macular lesions in granuloma annulare commonly found in adult women?
Anywhere on the body
What is a reported association with painful lesions on the hands in granuloma annulare?
Joint disease
In which disorder are granuloma annulare-like skin lesions and joint disease found?
Interstitial granulomatous dermatitis with arthritis
What is the suspected triggering factor for granuloma annulare lesions in children?
Nonspecific mild trauma
Which drug therapy has been associated with a granuloma annulare-like reaction?
Anti-inflammatory drugs
What has been linked to the development of interstitial granulomatous drug reaction?
Calcium channel blockers
Where is the predilection for granuloma annulare lesions in patients after bacille Calmette–Guérin immunization?
Vaccination sites
What is believed to represent a granulomatous reaction to actinic elastosis?
Annular elastolytic giant cell granuloma
What drug therapy has been associated with an observed granuloma annulare-like reaction?
Gold therapy
What is considered a distinct entity but may mimic granuloma annulare?
Interstitial granulomatous drug reaction
What triggering factor has been implicated in the development of granuloma annulare?
Viral infections
In which type of infection did chronic relapsing granuloma annulare flare due to the Koebner phenomenon?
Scabies infestation
Which disease has been found to be associated with the development of granuloma annulare?
Active tuberculosis
What is not included on the proposed mechanisms for the pathogenic mechanisms?
Bacterial infection leading to inflammation and tissue damage
What disease is granuloma annulare primarily associated with?
Thyroid disease
Which type of diabetes is primarily linked to granuloma annulare?
Type 1 insulin-dependent diabetes
What malignancy is granuloma annulare primarily associated with in adult patients?
Leukemia
Where is granuloma annulare commonly found in patients with thyroid disease?
Hypothyroidism
Where is the increased prevalence of dyslipidemia commonly found in patients with granuloma annulare?
In cases with an annular morphology
In which type of granuloma annulare is the increased prevalence of dyslipidemia more commonly found?
Generalized granuloma annulare
What is the main reason for obtaining a specimen for histopathologic examination in granuloma annulare?
To rule out generalized granuloma annulare or subcutaneous nodular disease
What is the characteristic histopathologic finding in granuloma annulare?
Devoid of nuclei and marked by a loss of definition of the collagen bundles
At what magnification is the diagnosis of granuloma annulare best made?
Low magnification
What is the typical appearance of the inflammation foci in granuloma annulare?
Oval foci with a central core of altered collagen surrounded by a wall of palisaded histiocytes
What is necessary when the presentation of granuloma annulare is atypical, lesions are symptomatic, or the diagnosis is in doubt?
Histopathologic analysis
Where are the changes usually observed in granuloma annulare?
Upper and middle dermis
What is the predominant pattern of inflammation in the generalized form of granuloma annulare?
Interstitial, nonpalisaded pattern
Which cells are admixed with histiocytes in the granuloma and in a perivascular distribution?
Lymphocytes and plasma cells
What may be necessary to demonstrate the necrobiotic plug in perforating granuloma annulare?
Examination of serial sections
What is the characteristic feature of subcutaneous granuloma annulare?
Large foci of necrobiosis in the deep dermis and subcutaneous fat
What is the usual treatment options for granuloma annulare?
Awaiting spontaneous resolution, topical steroids, and intralesional steroids
How long do most cases of localized granuloma annulare take to resolve spontaneously?
Within 2 years
What is a reported consequence of generalized granuloma annulare?
Scarring and milia formation
What diagnostic exam may be considered in the evaluation of generalized granuloma annulare?
Lipid studies
Test your knowledge of Granuloma Annulare, a relatively common skin disorder that can occur in different age groups and has various forms. Explore the characteristics, frequency, and occurrence of this disorder.
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