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      Scanning electron microscopy of granuloma annulare*

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          Abstract

          Light microscopy of granuloma annulare shows mucin deposition with lympho-histiocytic infiltrate. We describe the ultrastructural three-dimensional aspects of a typical case of granuloma with characteristic histopathological findings. At the ultrastructural level, affected collagen bundles and granular mucin deposition were observed. Round cells corresponding to lymphocytes were identified. Bigger oval cells, corresponding to isolated or palisading histiocytes were also found. The ultrastructural aspects overlap with light microscopy and contribute to its iconographic documentation.

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          Most cited references10

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          Diagnosis and management of granuloma annulare.

          Peggy Cyr (2006)
          Granuloma annulare is a benign, asymptomatic, self-limited papular eruption found in patients of all ages. The primary skin lesion usually is grouped papules in an enlarging annular shape, with color ranging from flesh-colored to erythematous. The two most common types of granuloma annulare are localized, which typically is found on the lateral or dorsal surfaces of the hands and feet; and disseminated, which is widespread. Localized disease generally is self-limited and resolves within one to two years, whereas disseminated disease lasts longer. Because localized granuloma annulare is self-limited, no treatment other than reassurance may be necessary. There are no well-designed randomized controlled trials of the treatment of granuloma annulare. Treatment recommendations are based on the pathophysiology of the disease, expert opinion, and case reports only. Liquid nitrogen, injected steroids, or topical steroids under occlusion have been recommended for treatment of localized disease. Disseminated granuloma annulare may be treated with one of several systemic therapies such as dapsone, retinoids, niacinamide, antimalarials, psoralen plus ultraviolet A therapy, fumaric acid esters, tacrolimus, and pimecrolimus. Consultation with a dermatologist is recommended because of the possible toxicities of these agents.
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            Granuloma annulare

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              Subcutaneous granuloma annulare: a review of 47 cases.

              The purpose of this study was to review and provide information regarding characteristic findings, diagnostic work-up, course, and treatment associated with subcutaneous granuloma annulare (SGA). The medical and surgical records of 47 patients with SGA, who were diagnosed and treated at our institution over the past 26 years, were reviewed. All patients presented with a painless soft tissue nodule(s) of the extremities or scalp. The mean age at presentation was 4.3 years, with 19% of the patients encountering one or more recurrences. The mean time of recurrence was 10 months. Definitive diagnosis in all patients was made by biopsy, and no patient progressed to any recognized systemic illness or connective tissue disorder. SGA is a benign inflammatory skin lesion that should be considered in the differential diagnosis of a subcutaneous nodule(s) of the scalp and/or distal extremities of an otherwise healthy child. Because the nodule(s) are benign and may recur with or without surgical biopsy, reassurance is the best management.
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                Author and article information

                Journal
                An Bras Dermatol
                An Bras Dermatol
                abd
                Anais Brasileiros de Dermatologia
                Sociedade Brasileira de Dermatologia
                0365-0596
                1806-4841
                Sep-Oct 2018
                Sep-Oct 2018
                : 93
                : 5
                : 740-742
                Affiliations
                [1 ]Department of Dermatology, Universidade Federal de Pelotas, Pelotas (RS), Brazil.
                [2 ]Department of Dermatology, Universidade Católica de Pelotas, Pelotas (RS), Brazil.
                [3 ]Discipline of Pathology, Universidade Católica de Pelotas, Pelotas (RS), Brazil.
                [4 ]Medical student, Dermatology League, Universidade Federal de Pelotas, Pelotas (RS), Brazil.
                Author notes
                Mailing Address: Hiram Larangeira de Almeida Jr. E-mail: hiramalmeidajr@ 123456hotmail.com
                Author information
                http://orcid.org/0000-0003-0705-1778
                http://orcid.org/0000-0001-6298-9414
                http://orcid.org/0000-0003-4412-9757
                http://orcid.org/0000-0002-5632-2346
                Article
                10.1590/abd1806-4841.20187409
                6106657
                30156630
                d808a84d-c474-42a3-b446-6ea0c6e23184

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivative License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way.

                History
                : 10 July 2017
                : 20 October 2017
                Categories
                Images in Dermatology

                histiocytes,microscopy, electron, scanning,mucins
                histiocytes, microscopy, electron, scanning, mucins

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