Disseminated granuloma annulare associated with systemic disorders: a case report and review of the literature
Disseminated granuloma annulare associated with systemic disorders: a case report and review of the literature

Summary/Abstract: Introduction Disseminated granuloma annulare, one of the rare clinical forms of granuloma annulare, is characterized by a prolonged evolution, frequent relapses and difficulty in finding the best therapeutic approach for the accompanying skin lesions. Case report We report the case of a female patient with disseminated granuloma annulare resistant to standard therapy, in evolution for more than 5 years, whose cutaneous lesions began to respond to topical treatment with calcineurin inhibitors only after the underlying systemic conditions (autoimmune thyroiditis and diabetes) were properly treated. Discussion The pathogenesis of the disease is not totally elucidated, various hypotheses of immunological origin are taken into consideration. The association and causal interaction between granuloma annulare and various systemic and autoimmune diseases has been brought to attention. Conclusion Granuloma annulare may be associated with various systemic diseases, such as diabetes mellitus and autoimmune thyroiditis, which interfere with the natural course of the skin lesions.

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