A 67-year-old woman presented with pruritic annular erythematous plaques with central hypopigmentation on the forearms, dorsal aspect of the hands, neck, and fingers of 3 to 4 months’ duration. What's wrong? DermTwitter
Annular elastolytic granuloma and GA differ in the fact that elastin degradation is characteristic of AEG compared to collagen degradation in GA. It is suspected that elastin degradation in AEG patients is caused by an immune response triggering phagocytosis of elastin by multinucleated histiocytes.Granuloma annulare can be ruled out and the diagnosis of AEG confirmed with the absence of elastin fibers and mucin on pathology.
Another study showed that 2 patients treated with psoralen plus UVA therapy reached complete clearance of AEG lasting at least 3 months after treatment.1. Lai JH, Murray SJ, Walsh NM. Evolution of granuloma annulare to mid-dermal elastolysis: report of a case and review of the literature. J Cutan Pathol. 2014;41:462-468. doi:10.1111/cup.12292 2. Klemke CD, Siebold D, Dippel E, et al. Generalised annular elastolytic giant cell granuloma. Dermatology. 2003;207:420-422. doi:10.1159/000074132 3.
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Rash and edemaA 2-year-old boy presented to the emergency department with a 1-day history of a diffuse, mildly pruritic rash and swelling of his knees, ankles, and feet following treatment of acute otitis media with amoxicillin for the previous 8 days. The child was mildly febrile and was refusing to walk. He had erythematous annular wheals on his chest, face, back, and extremities. Lymphadenopathy was absent. He was hospitalized, and 2 days later, his skin lesions enlarged and several formed dusky blue centers. He also developed swelling of his hands.What’s your diagnosis?
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