Deep granuloma annulare in adults

Area of Science:

• Dermatology
• Rheumatology
• Pathology

Background:

• Subcutaneous nodules with rheumatoid nodule histology can manifest in various conditions, including nonrheumatic diseases.
• When systemic disease is absent, these nodules are often diagnosed as deep granuloma annulare.
• While common in children, adult cases of deep granuloma annulare without systemic disease are infrequently reported.

Observation:

• Two adult patients presented with multiple subcutaneous nodules overlying joints.
• Histopathological examination revealed features consistent with rheumatoid nodules.
• Neither patient exhibited other clinical or laboratory signs of rheumatic disease.

Findings:

• The observed cases suggest an adult presentation of deep granuloma annulare.
• These findings highlight the potential for rheumatoid nodule-like lesions in adults without underlying rheumatic disease.
• The study underscores the broad clinical variability of nodular lesions and their pathogenesis.

Implications:

• Recognizing this adult form of deep granuloma annulare is crucial for accurate diagnosis and management.
• It prompts consideration of nonrheumatic causes for rheumatoid nodule-like lesions in adults.
• Further research into the pathogenesis of deep granuloma annulare is warranted to understand its diverse clinical manifestations.