SUBCUTANEOUS GRANULOMA ANNULARE IN CHILDREN AND DIPHTHERIA - TETANUS VACCINATION
Abstract:
Introduction: Granuloma Annulare (GA) is a relatively common idiopathic granulomatous
disorder of the dermis and subcutaneous tissue, clinically characterized by papular-nodular skin lesions
with polymorphic character. Clinical case: We are presenting the case of a 14-year old female patient
with a relatively recent onset of well-defined erythematosus nodules on the back side of the knees, which
then extended to the shins and legs, presenting a discreet squamous collar at the periphery with discreet
pruritus. Before the start of the eruption, the patient had been vaccinated against tetanus and diphtheria.
From a clinical point of view, the lesions posed some problems with differential diagnosis of other
diseases such as: erythema elevatum et diutinum, verrucous lichen, erythema nodosum, panniculitis,
sarcoidosis etc. The histopathological exam confirmed the diagnosis of granuloma annulare of the
subcutaneous type. Conclusion: Subcutaneous granuloma annulare represents a rare
clinicopathological form of granuloma annulare; the change of the immune status post vaccination
could be a trigger for the onset of the disease, characterized by the occurence of lesions.
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