Localized granuloma annulare and autoimmune thyroiditis in a Saudi patient: report of a new case

The association of granuloma annulare (GA) and autoimmune thyroiditis has been documented in the literature in 13 previous cases. However, the pathogenesis of GA remains obscure. Possible pathogenetic factors suggested include: humoral and delayed type hypersensitivity, vascular damage, metabolic disorder, or, primary collagen and/or elastin alteration mediated through an immunologic mechanism. We present herein the report of a 37-year old Saudi female who presented with autoimmune thyroiditis associated with GA. The patient was managed with clobetasol propionate, intra-lesional prednisolone and neomercasol. There was complete resolution of the GA lesions and the patient has remained euthyroid after a few weeks. This presentation is a further evidence that GA and autoimmune thyroiditis may be associated.