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PEDIATRICS Vol. 107 No. 3 March 2001, p. e42

ELECTRONIC ARTICLE:
Subcutaneous Granuloma Annulare in Childhood: Clinicopathologic Features in 34 Cases

Received Jul 17, 2000; accepted Nov 2, 2000.

Karen L. Grogg and Antonio G. Nascimento

From the Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.

Objective.  To gather clinicopathologic data on subcutaneous granuloma annulare (SGA), a subtype of granuloma annulare that occurs exclusively in children and is histologically similar to rheumatoid nodules.

Design.  Retrospective record review.

Patients.  Children <10 years old in whom SGA, deep granuloma annulare, or necrobiotic granuloma was diagnosed at the Mayo Clinic (Rochester, MN) from 1983 to 1998.

Results.  Thirty-four patients (21 girls and 13 boys; average age at diagnosis: 4.6 years) were found to have SGA. The lesions predominantly occurred in the lower extremity, especially in a pretibial location. Local recurrence within 1 month to 7 years was documented in 38.2%; recurrence at other locations was documented in 14.7%. Average follow-up was 60 months; during follow-up, no patients developed signs or symptoms of rheumatologic disease. Insulin-dependent diabetes mellitus was diagnosed in 2 patients, 1 before the development of SGA and 1 after it by 1 month.

Conclusions.  SGA is a lesion that presents as subcutaneous nodules on the lower extremities, hands, or scalp in young children. Recurrence is common but usually does not warrant additional biopsy.  Key words:  childhood, diabetes mellitus, insulin-dependent, granuloma annulare, necrobiotic granuloma, subcutaneous granuloma annulare.