M. TÜRKMEN, İ. ERTAM, G. KANDİLOĞLU, T. DERELİ

Subkutan granüloma annulare

Beş yaşında erkek hasta iki yıldır alt ekstremitelerde yer alan ağrısız, sert, mobil subkutan nodüller nedeni ile başvurdu. Nodüllerden birinin histopatolojik incelemesi “palizadik granülom”la uyumlu bulundu. Romatoid faktörü ve diğer immünolojik belirteçleri negatif saptandı. Hastaya klinik ve laboratuar bulgularıyla romatoid artrit dışlandıktan sonra ‘subkutan granüloma anulare (SGA)' tanısı koyuldu. Benign romatoid nodül, psödoromatoid nodül olarak da adlandırılan subkutan granüloma annulare (SGA), dermis ve subkutan dokunun benign granülomatöz hastalığıdır. Ekstremitelerin ekstansör yüzleri, palmoplantar alanlar ve saçlı deri yerleşimli ağrısız, inflamasyon bulgularının eşlik etmediği, mobil subkutan nodüllerle karakterizedir. SGA, klinik ve histopatolojik olarak romatoid nodüllerle karışabileceğinden hastaların dikkatli değerlendirilmesi gerekmektedir. Burada, SGA tanısı alan bir olgu tipik klinik görünümüne dikkat çekmek ve literatür ışığında tartışmak amacıyla sunulmaktadır.

Subcutaneous granuloma annulare

A 5-year old boy presented with a two year history of painless, firm, mobile subcutaneous nodules on his lower extremities. Histopathologic examination of one of these nodules revealed palisading granuloma. Rheumatoid factor and other immunologic markers were negative. After exclusion of rheumatic artritis by evaluation with clinical and laboratuary findings, he was diagnosed with ‘subcutaneous granuloma annulare (SGA)'. SGA, known as benign rheumatoid nodule or pseudorheumatoid nodule, is a benign granulomatous disease of the dermis and subcutaneous tissue. It is characterized by painless, mobile, subcutaneous nodules with no inflammatory appearance at the skin surface, most commonly located on the anterior aspects of the extremities, palmo-plantar area and head. The patient should be evaluated carefully since SGA resembles rheumatoid nodules, both clinically and on histopathologic examination. Here a case of SGA is presented because of its typical clinical appearance and is discussed on the basis of a literature review.

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