Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature

Granuloma annulare has been associated with systemic disease including diabetes mellitus. We report a case of a 62-year-old Japanese woman with generalized erythematous granuloma annulare who showed remission after substantial improvement in hyperlipidemia following a strict lipid-lowering diet. Th...

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Autores principales:	Soko Watanabe, Masaru Tanaka, Ken Kobayashi, Mizuki Sawada, Sumiko Ishizaki, Koji Tsurui, Mariko Fujibayashi
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2014
Materias:	generalized erythematous granuloma annulare glucose intolerance hyperlipidemia Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/fa1ec3429eb640d48326b0a8a8035547
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spelling	oai:doaj.org-article:fa1ec3429eb640d48326b0a8a80355472021-11-17T08:32:25ZRemission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature10.5826/dpc.0401a172160-9381https://doaj.org/article/fa1ec3429eb640d48326b0a8a80355472014-01-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/917https://doaj.org/toc/2160-9381 Granuloma annulare has been associated with systemic disease including diabetes mellitus. We report a case of a 62-year-old Japanese woman with generalized erythematous granuloma annulare who showed remission after substantial improvement in hyperlipidemia following a strict lipid-lowering diet. The lesion appeared in the lower abdomen one year before current presentation and subsequently spread to other areas of the trunk despite treatment with topical steroid and oral epinastine hydrochloride. Physical examination showed a well-demarcated erythematous plaque measuring 10 cm in diameter with fine scales on the left abdomen, and slightly indurated pinkish plaques of up to 5 cm in diameter on the right side of the abdomen and axillae. Clinical laboratory tests showed mild glucose intolerance (HbA1c 6.2%), mild liver dysfunction (AST: 86 IU/L, ALT: 76 IU/l), slight hypercholesterolemia (total cholesterol: 235 mg/dl), and severe hyperlipidemia (triglyceride: 962 mg/ml). Histopathological examination of the lesions showed homogenization of collagen fibers and granulomatous infiltrates between fibers in the upper and middle dermis. A diagnosis of generalized erythematous granuloma annulare was established based on the clinical and histopathological findings, especially with the distribution on more than one anatomic site. A lipid-lowering diet for three months resulted in major improvement of hyperlipidemia and remission of the skin lesions. A review of generalized erythematous granuloma annulare in the Japanese literature indicated a well-known association of granuloma annulare with diabetes mellitus, however, the relation with hyperlipidemia was described only recently. This case suggests a possible relationship between granuloma annulare and hyperlipidemia, with possible improvement of granuloma annulare with a lipid-lowering diet. Soko WatanabeMasaru TanakaKen KobayashiMizuki SawadaSumiko IshizakiKoji TsuruiMariko FujibayashiMattioli1885articlegeneralized erythematous granuloma annulareglucose intolerancehyperlipidemiaDermatologyRL1-803ENDermatology Practical & Conceptual (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	generalized erythematous granuloma annulare glucose intolerance hyperlipidemia Dermatology RL1-803
spellingShingle	generalized erythematous granuloma annulare glucose intolerance hyperlipidemia Dermatology RL1-803 Soko Watanabe Masaru Tanaka Ken Kobayashi Mizuki Sawada Sumiko Ishizaki Koji Tsurui Mariko Fujibayashi Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature
description	Granuloma annulare has been associated with systemic disease including diabetes mellitus. We report a case of a 62-year-old Japanese woman with generalized erythematous granuloma annulare who showed remission after substantial improvement in hyperlipidemia following a strict lipid-lowering diet. The lesion appeared in the lower abdomen one year before current presentation and subsequently spread to other areas of the trunk despite treatment with topical steroid and oral epinastine hydrochloride. Physical examination showed a well-demarcated erythematous plaque measuring 10 cm in diameter with fine scales on the left abdomen, and slightly indurated pinkish plaques of up to 5 cm in diameter on the right side of the abdomen and axillae. Clinical laboratory tests showed mild glucose intolerance (HbA1c 6.2%), mild liver dysfunction (AST: 86 IU/L, ALT: 76 IU/l), slight hypercholesterolemia (total cholesterol: 235 mg/dl), and severe hyperlipidemia (triglyceride: 962 mg/ml). Histopathological examination of the lesions showed homogenization of collagen fibers and granulomatous infiltrates between fibers in the upper and middle dermis. A diagnosis of generalized erythematous granuloma annulare was established based on the clinical and histopathological findings, especially with the distribution on more than one anatomic site. A lipid-lowering diet for three months resulted in major improvement of hyperlipidemia and remission of the skin lesions. A review of generalized erythematous granuloma annulare in the Japanese literature indicated a well-known association of granuloma annulare with diabetes mellitus, however, the relation with hyperlipidemia was described only recently. This case suggests a possible relationship between granuloma annulare and hyperlipidemia, with possible improvement of granuloma annulare with a lipid-lowering diet.
format	article
author	Soko Watanabe Masaru Tanaka Ken Kobayashi Mizuki Sawada Sumiko Ishizaki Koji Tsurui Mariko Fujibayashi
author_facet	Soko Watanabe Masaru Tanaka Ken Kobayashi Mizuki Sawada Sumiko Ishizaki Koji Tsurui Mariko Fujibayashi
author_sort	Soko Watanabe
title	Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature
title_short	Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature
title_full	Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature
title_fullStr	Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature
title_full_unstemmed	Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature
title_sort	remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the japanese literature
publisher	Mattioli1885
publishDate	2014
url	https://doaj.org/article/fa1ec3429eb640d48326b0a8a8035547
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Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature

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