Generalized Granuloma Annulare―A Patient who Responded to Narrow-band UVB and Etretinate Therapy and Review of the Japanese Literature

Toyoda Mito, Kura Noriko, Imafuku Shinichi, Moroi Yoichi, Urabe Kazunori, Furue Masutaka, Koga Tetsuya

doi:10.14924/dermatol.116.2265

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汎発性環状肉芽腫―Narrow-band UVBとエトレチナート内服で治療した1例と本邦報告246例の集計―
ハンハツセイカンジョウニクゲシュ Narrow band UVB トエトレチナートナイフクデチリョウシタ 1レイトホンポウホウコク 246レイノシュウケイ

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We report the case of a 54-year-old man who developed red papules in an annular arrangement on the trunk and extremities 6 months before his first visit. He was born in Kagoshima, Japan. Histopathologically palisading granulomas, seen as collagen degeneration surrounded by epithelioid cells, histiocytes, lymphocytes and multinucleated giant cells, were observed in the dermis, supporting the diagnosis of generalized granuloma annulare (GGA). As a complication, non-insulin-dependent diabetes mellitus was detected by a 75 g oral glucose tolerance test. Anti-HTLV-1 antibody was positive, and adult T-cell leukemia/lymphoma (ATL)-like atypical cells were found in the peripheral blood, suggesting smoldering type ATL. To our knowledge, there are 246 Japanese cases of GGA, but our case has been the only one associated with ATL. The proviral DNA from the specimen analyzed by Southern blotting was negative, and we concluded that ATL was not responsible for the formation of the GGA. The eruption was successfully treated with a combination of irradiation with narrow-band UVB, oral etretinate, and topical steroid.

Journal

The Japanese Journal of Dermatology

The Japanese Journal of Dermatology 116 (14), 2265-2272, 2006

Japanese Dermatological Association

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