Subcutaneous granuloma annulare induced by acetazolamide

Area of Science:

• Dermatology
• Pediatrics
• Pharmacology

Background:

• Idiopathic intracranial hypertension (IIH) is a neurological condition requiring treatment.
• Acetazolamide is a common medication used to manage IIH.
• Subcutaneous granuloma annulare (SGA) is a benign inflammatory skin condition.

Observation:

• A 9-year-old boy developed recurring subcutaneous nodules on his legs and knees.
• These lesions appeared specifically after receiving acetazolamide for IIH.
• Skin biopsy confirmed the diagnosis of subcutaneous granuloma annulare.

Findings:

• Histopathology revealed palisaded granulomas and mucin deposition, characteristic of SGA.
• The temporal relationship between acetazolamide use and SGA onset was noted.
• This represents the first documented association between SGA and acetazolamide.

Implications:

• Acetazolamide may trigger or exacerbate subcutaneous granuloma annulare in susceptible individuals.
• Clinicians should consider SGA in patients presenting with similar skin lesions during acetazolamide therapy.
• Further research is warranted to elucidate the mechanism underlying this potential drug-induced dermatosis.