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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Generalized granuloma annulare is a rare variant of granuloma annulare affecting the trunk and extremities with a multitude of lesions. In contrast to localized granuloma annulare, generalized granuloma annulare occurs in older patients, shows a stronger association with diabetes, and is characteristically chronic. Like our 55-year-old patient, most patients present with papules and annular plaques; less often, macular or non-annular lesions may be encountered. Histology often fails to show necrobiotic or necrotic connective tissue changes demarcated by a palisading granuloma. Instead, there are diffuse dermal, band-like or nodular aggregations of histiocytes intermingled with some multinucleated giant cells and a predominantly lymphocytic infiltrate in the periphery. Because of its special characteristics, it has been suggested that generalized granuloma annulare might constitute a separate disease entity and that it should be classed among the primary cutaneous histiocytoses as a diffuse dermal histiocytosis. Using immunohistochemistry to determine the macrophage phenotype of the lesional histiocytes, we have shown that generalized granuloma annulare is not a cutaneous histiocytosis. Neither MS-1 high-molecular-weight protein, a new specific marker for cutaneous non-Langerhans cell histiocytoses, nor CD1a, the well-known marker for Langerhans cells and Langerhans cell histiocytoses, is expressed by the lesional histiocytes of our patient. In contrast, the antigen expression pattern was diagnostic for non-infectious granulomas and was highly similar to that in localized granuloma annulare. In contrast to the successful treatment of localized granuloma annulare reported with intralesional interferon beta-1, systemic treatment with interferon alpha-2b (9 x 10(6) units three times a week) was ineffective.
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PMID:[Generalized granuloma annulare or diffuse dermal histiocytosis?]. 755 26

Generalized granuloma annulare (GGA) is an uncommon cutaneous disease of unknown origin, characterized by numerous flesh-colored to erythematous papules with or without annular configuration. Clinical associations of GGA with diabetes mellitus, thyroid diseases, malignancies, AIDS, and chronic hepatitis C virus infection have been reported. Therapy has been attempted with various modalities with moderate efficacy. We report a case of GGA presenting as arcuate dermal erythema with excellent therapeutic response to corticosteroid therapy (a short course of intramuscular corticosteroids, a prolonged low oral dose, and topical corticosteroids).
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PMID:Generalized granuloma annulare presenting as arcuate dermal erythema. 2037 71

Generalized granuloma annulare (GGA) and eruptive xanthoma are dermatological diseases that occasionally share some clinical and histological similarities. Associated underlying medical conditions and clinical course are essential guides to the proper diagnosis. The authors reported a case ofdisseminatedyellowish-redpapules in a 24-year-old female with high levels of serum fasting blood sugar triglycerides, and cholesterol. The provisional diagnosis was eruptive xanthoma but histopathology and immunoperoxidase study revealed granuloma annulare. The remission of the skin lesions soon after control of dyslipidemia and diabetes mellitus is not typical for the usual GGA, which has a chronic relapsing course and a poor response to treatment. Further studies are required to differentiate these two entities when they come into the clinicopathological mimicry.
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PMID:Generalized granuloma annulare presenting with lesions resembling eruptive xanthoma. 2372 Sep 88