Multiple lesions of granuloma annulare following BCG vaccination: case report and review of the literature
Identifieur interne : 009E30 ( Main/Exploration ); précédent : 009E29; suivant : 009E31Multiple lesions of granuloma annulare following BCG vaccination: case report and review of the literature
Auteurs : Maki Kakurai [Japon] ; Tomoharu Kiyosawa [Japon] ; Mamitaro Ohtsuki [Japon] ; Hidemi Nakagawa [Japon]Source :
- International Journal of Dermatology [ 0011-9059 ] ; 2001-09.
Abstract
A 12‐year‐old Japanese boy presented with asymptomatic, multiple annular, erythematous, infiltrated lesions on his left upper arm and right knee as well as the lateral side of the right ankle joint. He had noted these erythematous lesions five days after bacille Calmette‐Guerin (BCG) vaccination. The lesions gradually enlarged and increased in number. Topical corticosteroid therapy for several weeks failed to improve the lesions. There was no familial history of pulmonary tuberculosis. Physical examination revealed extensively disseminated, round, erythematous plaques and papules. Some plaques showed an annular configuration, varying in diameter from 5 to 45 mm, on his left upper arm, right knee and the lateral side of the right ankle joint (Fig. 1). One month after BCG vaccination, reddish‐brown, infiltrated erythema with crusts was observed at the BCG vaccination site (Fig. 2). Tuberculin test showed an erythema with induration measuring 2.5 cm in diameter at 48 h. Routine laboratory tests including complete blood cell count, erythrocyte sedimentation rate and biochemical analysis were within normal limits. Serum glucose level and GhbA1c were also normal. Annular erythematous lesion on left lateral malleolus Multiple, grouped, erythematous papules with crust, exactly corresponding to previous multipuncture BCG site Histopathologically, a biopsy specimen obtained from an annular erythematous plaque on the lateral side of his right ankle joint revealed marked pale staining, well‐circumscribed degenerated collagen bundles surrounded by palisading histiocytes and lymphocytes in the dermis (Fig. 3). Alcian blue stain was positive among degenerated collagen fibers. An immunofluorescence study revealed IgG and C3 deposits in dermal vessels. These histologic features were consistent with granuloma annulare. Area of degenerated collagen surrounded by palisaded histiocytes Two months later, the margins of the erythematous lesions had spontaneously faded and, within 7 months, had completely resolved. Reddish‐brown erythema at the BCG vaccination site had not disappeared.
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DOI: 10.1046/j.1365-4362.2001.01248-2.x
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He had noted these erythematous lesions five days after bacille Calmette‐Guerin (BCG) vaccination. The lesions gradually enlarged and increased in number. Topical corticosteroid therapy for several weeks failed to improve the lesions. There was no familial history of pulmonary tuberculosis. Physical examination revealed extensively disseminated, round, erythematous plaques and papules. Some plaques showed an annular configuration, varying in diameter from 5 to 45 mm, on his left upper arm, right knee and the lateral side of the right ankle joint (Fig. 1). One month after BCG vaccination, reddish‐brown, infiltrated erythema with crusts was observed at the BCG vaccination site (Fig. 2). Tuberculin test showed an erythema with induration measuring 2.5 cm in diameter at 48 h. Routine laboratory tests including complete blood cell count, erythrocyte sedimentation rate and biochemical analysis were within normal limits. Serum glucose level and GhbA1c were also normal. Annular erythematous lesion on left lateral malleolus Multiple, grouped, erythematous papules with crust, exactly corresponding to previous multipuncture BCG site Histopathologically, a biopsy specimen obtained from an annular erythematous plaque on the lateral side of his right ankle joint revealed marked pale staining, well‐circumscribed degenerated collagen bundles surrounded by palisading histiocytes and lymphocytes in the dermis (Fig. 3). Alcian blue stain was positive among degenerated collagen fibers. An immunofluorescence study revealed IgG and C3 deposits in dermal vessels. These histologic features were consistent with granuloma annulare. Area of degenerated collagen surrounded by palisaded histiocytes Two months later, the margins of the erythematous lesions had spontaneously faded and, within 7 months, had completely resolved. Reddish‐brown erythema at the BCG vaccination site had not disappeared.</div></front></TEI><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Kakurai, Maki" sort="Kakurai, Maki" uniqKey="Kakurai M" first="Maki" last="Kakurai">Maki Kakurai</name></noRegion><name sortKey="Kiyosawa, Tomoharu" sort="Kiyosawa, Tomoharu" uniqKey="Kiyosawa T" first="Tomoharu" last="Kiyosawa">Tomoharu Kiyosawa</name><name sortKey="Nakagawa, Hidemi" sort="Nakagawa, Hidemi" uniqKey="Nakagawa H" first="Hidemi" last="Nakagawa">Hidemi Nakagawa</name><name sortKey="Ohtsuki, Mamitaro" sort="Ohtsuki, Mamitaro" uniqKey="Ohtsuki M" first="Mamitaro" last="Ohtsuki">Mamitaro Ohtsuki</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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