<\/span><\/h2>\nThe histology examination view of the granuloma annulare shows a granulomatous<\/span> inflammatory<\/span> pattern located within the superficial and middle dermis<\/span>.<\/p>\n\n- Figure 1. Closer inspection reveals palisade of histiocytes<\/span> around an approach of necrobiosis<\/span> and increased mucin<\/span> statement<\/span>.<\/li>\n
- Figure 2, Figure 3. The involved dermis appears normal. Multinucleate<\/span> giant cells<\/span> they are seen frequently.<\/li>\n
- Figure 4. A slight perivascular<\/span> and interstitial<\/span> lymphocytic<\/span> infiltrate<\/span> can be seen in the surrounding dermis with scattered neutrophils<\/span><\/span> and eosinophils<\/span>. Plasma<\/span> Cells are rare.<\/li>\n
- Associated vascular<\/span> fibrin<\/span> deposition and nuclear<\/span> powder suggestive of vasculitis<\/span> It seems to be a rare find.<\/li>\n<\/ul>\n\n
<\/span>Pathology of granuloma annulare<\/span><\/h5>\n<\/section>\n\n\n
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Figure 1<\/p>\n
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Figure 2<\/p>\n
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figure 3<\/p>\n
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Figure 4<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>\nHistological<\/span> variants of the granuloma annulare<\/span><\/h2>\nSubcutaneous<\/span> GA: In this variant, the inflammatory infiltrate is predominantly within the deep dermis and extends into the subcutaneous tissue (Figure 5, 6). Large areas of necrobiosis can be seen along with a greater number of eosinophils (Figures 7, 8, 9).<\/p>\n\n<\/span>Pathology of subcutaneous annular granuloma<\/span><\/h5>\n<\/section>\n\n\n
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Figure 5<\/p>\n
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Figure 6<\/p>\n
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Figure 7<\/p>\n
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Figure 8<\/p>\n
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Figure 9<\/p>\n<\/p><\/div>\n<\/section>\n
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Mitotically active variant: While typical mitotic activity is low, a mitotically active variant is recognized that might otherwise cause concern about a proliferative<\/span> injury<\/span>. Caution is recommended in these cases to exclude epithelioid<\/span> sarcoma<\/span> as discussed below.<\/p>\nPerforating GA: Here it can be seen that the inflammatory infiltrate is eliminated through the epidermis<\/span> through a channel formed between epidermal<\/span> descents.<\/p>\nDisseminated<\/span> GA: While histology may be identical to typical GA, the infiltrate may be sparse and retained within the papillary dermis<\/span>. Lichen nitido is sometimes considered in these cases.<\/p>\nInterstitial GA: the low-power pattern is different, shows a 'busy dermis' and lacks necrobiotic and mucinous foci. High power reveals the interstitial infiltrate of benign<\/span> Histiocytes appearing. Although less visible, an increase in mucin is often seen around the inflammatory infiltrate. In the presence of many eosinophils and interface changes, an interstitial granulomatous drug reaction should be considered.<\/p>\n\n
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<\/span>Special spots in granuloma annulare<\/span><\/h2>\nMucin stains such as colloidal iron and alcian blue can be used to highlight the increase connective tissue<\/span> mucins<\/p>\n<\/span>\nDifferential diagnosis<\/span> of granuloma annulare<\/span><\/h2>\nLipoid necrobiosis: layered with open necrobiotic foci. Lacks mucin. An increased number of plasma cells may be a clue.<\/p>\n
Rheumatoid nodule<\/span>: The changes seen here are more similar to the subcutaneous variant of GA. The discriminatory characteristics observed in the rheumatoid nodule include the presence of larger areas of eosinophilic<\/span> necrobiosis and lack of mucin deposition. The medical history is usually informative.<\/p>\nEpithelioid sarcoma: always think twice when diagnosing GA in the digits<\/span>. While the low power pattern may be similar due to the eosinophilic areas of necrosis<\/span>a closer inspection will always reveal a atypical<\/span> infiltrate. Immunohistochemistry<\/span> is definitive in difficult injuries that show Epithelial<\/span> membrane antigen<\/span> (EMA) and Cytokeratin<\/span> (CK) positivity.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"Histolog\u00eda de granuloma anular La vista de exploraci\u00f3n de la histolog\u00eda del granuloma anular muestra un granulomatoso inflamatorio patr\u00f3n situado dentro de lo superficial y medio dermis. Figura 1. Una…<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[205],"class_list":["post-8213","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones","tag-patologia"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/8213","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=8213"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/8213\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=8213"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=8213"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=8213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}