Granuloma annulare on the palms in an elderly patient

Granuloma annulare is a relatively common, idiopathic, benign inflammatory dermatosis, with a varied clinical presentation that often makes diagnosis difficult. It mainly affects the extremities, such as the dorsa of the hands and feet, forearms and legs. Palmar and plantar regions are generally spared. It occurs mainly in young female patients. The presentation of the palmar variant in an elderly patient is a rarity.

Keywords:
Granuloma annulare; Hand; Methotrexate

Authorship

Danielle Santana Mello Mailing Address: Danielle Santana Mello. E-mail: danizin.mello@gmail.com

Dermatology Service, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.Universidade do Estado do Rio de JaneiroBrazilRio de Janeiro, RJ, BrazilDermatology Service, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.

https://orcid.org/0000-0001-5458-1451

Mariana Rita de Novaes Fernandes

https://orcid.org/0000-0003-1359-7187

Alexandre Carlos Gripp

Discipline of Dermatology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.Universidade do Estado do Rio de JaneiroBrazilRio de Janeiro, RJ, BrazilDiscipline of Dermatology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.

https://orcid.org/0000-0003-2217-6704

Maria de Fátima Guimarães Scotelaro Alves

Division of Dermatopathology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.Universidade do Estado do Rio de JaneiroBrazilRio de Janeiro, RJ, BrazilDivision of Dermatopathology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.

https://orcid.org/0000-0001-7003-6250

Mailing Address: Danielle Santana Mello. E-mail: danizin.mello@gmail.com

Conflict of interest: None.

AUTHORS' CONTRIBUTIONS

Danielle Santana Mello

0000-0001-5458-1451

Statistical analysis, Approval of the final version of the manuscript, Conception and planning of the study, Elaboration and writing of the manuscript, Obtaining, analyzing and interpreting the data, Effective participation in research orientation, Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied, Critical review of the literature

Mariana Rita de Novaes Fernandes

0000-0003-1359-7187

Statistical analysis, Approval of the final version of the manuscript, Conception and planning of the study, Elaboration and writing of the manuscript, Obtaining, analyzing and interpreting the data, Effective participation in research orientation, Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied, Critical review of the literature

Alexandre Carlos Gripp

0000-0003-2217-6704

Statistical analysis, Approval of the final version of the manuscript, Conception and planning of the study, Elaboration and writing of the manuscript, Obtaining, analyzing and interpreting the data, Effective participation in research orientation, Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied, Critical review of the literature, Critical review of the manuscript

Maria de Fátima Guimarães Scotelaro Alves

0000-0001-7003-6250

Statistical analysis, Approval of the final version of the manuscript, Conception and planning of the study, Elaboration and writing of the manuscript, Obtaining, analyzing and interpreting the data, Effective participation in research orientation, Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied, Critical review of the literature, Critical review of the manuscript

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (4)

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Figure 1
Granuloma annulare. Hyperkeratosis and acanthosis. We noted the presence of palisading histiocytes and macrophages throughout the dermis, surrounding fragments of collagen fiber bundles in its interior (Hematoxylin & eosin, x400)

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Figure 2
Granuloma annulare. The presence of mucin was observed in the center of the palisade (Colloidal iron, x1000)

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Figure 3
Palmar granuloma annulare. Normochromic papules localized in the palmar region; papules identified by white arrows

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Figure 4
Palmar granuloma annulare. Normochromic papules localized in the palmar region; papules identified by white arrows

Figure 1 Granuloma annulare. Hyperkeratosis and acanthosis. We noted the presence of palisading histiocytes and macrophages throughout the dermis, surrounding fragments of collagen fiber bundles in its interior (Hematoxylin & eosin, x400)

Figure 2 Granuloma annulare. The presence of mucin was observed in the center of the palisade (Colloidal iron, x1000)

Figure 3 Palmar granuloma annulare. Normochromic papules localized in the palmar region; papules identified by white arrows

Figure 4 Palmar granuloma annulare. Normochromic papules localized in the palmar region; papules identified by white arrows

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E-mail: revista@sbd.org.br

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