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Periocular subperiosteal deep granuloma annulare in a child
Jonathan J Dutton1, George K Escaravage
1Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7040, USA. jonathan_dutton@med.unc.edu
Insights
A rare case of deep granuloma annulare presented as a subperiosteal orbital mass in a child. This benign condition, typically self-limiting, can mimic other orbital lesions.
Area of Science:
- Dermatology
- Ophthalmology
- Pediatric Pathology
Background:
- Deep granuloma annulare (DGA) is a rare inflammatory condition.
- It is often misdiagnosed as rheumatoid nodules.
- DGA typically presents as subcutaneous nodules.
Observation:
- A 2-year-old child presented with a painless 6-month periorbital mass.
- Associated cutaneous nodules resolved spontaneously.
- The subperiosteal orbital mass was surgically excised.
Findings:
- Histopathological examination confirmed deep granuloma annulare.
- The lesion was located in a subperiosteal position along the superior orbital rim.
- This represents the first reported case of DGA in this specific location.
Implications:
- Highlights the importance of considering DGA in the differential diagnosis of pediatric orbital masses.
- Emphasizes the benign and often self-limiting nature of DGA.
- Suggests further investigation for systemic associations in rare cases.
Abstract:
A 2-year-old child presented with a painless subperiosteal periorbital mass of 6 months' duration. This was associated with several small cutaneous nodules that resolved spontaneously before surgical excision of the orbital lesion. Excisional biopsy of the lesion revealed a deep granuloma annulare in a subperiosteal location along the superior orbital rim. The patient did well after surgery, with no evidence of recurrence after 18 months. Deep granuloma annulare is a rare lesion often confused with rheumatoid nodule. It has not previously been reported in a subperiosteal location around the orbit. Although granuloma annulare is typically benign and often self-limiting, in some cases it can be associated with systemic disease.
