Sporotrichoid granuloma annulare-like dermatitis associated with systemic B-cell lymphoma

Dermatol Online J. 2015 Sep 17;21(9):13030/qt5tp738q9.

Abstract

Importance: Granuloma annulare is typically a benign, self-limited disease. Atypical presentations have been reported in association with systemic disease, including malignancy. Such patients may require additional diagnostic studies to assess for underlying malignancy. We report a patient with extensive sporotrichoid granuloma annulare-like dermatitis in association with systemic B-cell lymphoma.

Observations: An 83-year-old man with a three-year history of progressive sporotrichoid annular plaques and nodules on the arm developed ipsilateral retroauricular palpable lymphadenopathy, the latter consistent with B-cell lymphoma. Multiple skin biopsies of the plaques and nodules revealed granuloma annulare-like dermatitis. Lesions were unresponsive to intralesional and intramuscular corticosteroids, antibiotics, and antifungal agents, but rapidly improved following initiation of rituximab to treat his underlying lymphoma.

Conclusions and relevance: Atypical presentations of granuloma annulare including granuloma annulare-like dermatitis warrant evaluation for systemic malignancy in a subset of patients.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Arm
  • Granuloma Annulare / etiology*
  • Granuloma Annulare / pathology
  • Humans
  • Lymphoma, B-Cell / complications*
  • Lymphoma, B-Cell / drug therapy
  • Male
  • Rituximab / therapeutic use

Substances

  • Antineoplastic Agents
  • Rituximab