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Granuloma Annulare
Arthur B. Meyers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Subcutaneous granuloma annulare (SGA)
            • Synonyms

              • Benign rheumatoid nodule, pseudorheumatoid nodule, deep granuloma annulare, subcutaneous palisading granuloma, palisading granuloma nodosum, isolated subcutaneous nodule, isolated subcutaneous granuloma, necrobiotic granuloma
            • Definitions

              • Benign inflammatory skin lesion of unknown etiology
              • 4 clinically distinct subtypes
                • Localized
                  • Most common type
                  • Nodular ringed skin eruption; typically on dorsum of hands, feet, forearms, legs, & thighs
                  • Children & young adults; 2/3 present < 30 years old
                • Generalized
                  • Similar to localized form but more widespread
                  • Present < 10 or > 40 years of age
                • Perforating
                  • Superficial lesion that perforates epidermis; evident on clinical exam
                • Subcutaneous: Subtype of concern to radiologists
                  • Nonspecific nodular subcutaneous mass
                  • Almost exclusively seen in children

            IMAGING

            • General Features

              • Radiographic Findings

                • Ultrasonographic Findings

                  • CT Findings

                    • MR Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. Fathi K et al: Subcutaneous granuloma annulare of the penis associated with a urethral anomaly: case report and review of the literature. Pediatr Dermatol. 31(4):e100-3, 2014
                                      2. Agrawal AK et al: An unusual presentation of subcutaneous granuloma annulare in association with juvenile-onset diabetes: case report and literature review. Pediatr Dermatol. 29(2):202-5, 2012
                                      3. Navarro OM: Soft tissue masses in children. Radiol Clin North Am. 49(6):1235-59, vi-vii, 2011
                                      4. Navarro OM et al: Pediatric soft-tissue tumors and pseudotumors: MR imaging features with pathologic correlation: part 1. Imaging approach, pseudotumors, vascular lesions, and adipocytic tumors. Radiographics. 29(3):887-906, 2009
                                      5. Grogg KL et al: Subcutaneous granuloma annulare in childhood: clinicopathologic features in 34 cases. Pediatrics. 107(3):E42, 2001
                                      6. Chung S et al: Subcutaneous granuloma annulare: MR imaging features in six children and literature review. Radiology. 210(3):845-9, 1999
                                      7. De Maeseneer M et al: Subcutaneous granuloma annulare: MR imaging findings. Skeletal Radiol. 27(4):215-7, 1998
                                      8. Kransdorf MJ et al: Subcutaneous granuloma annulare: radiologic appearance. Skeletal Radiol. 27(5):266-70, 1998
                                      9. Vandevenne JE et al: Subcutaneous granuloma annulare: MR imaging and literature review. Eur Radiol. 8(8):1363-5, 1998
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Subcutaneous granuloma annulare (SGA)
                                                • Synonyms

                                                  • Benign rheumatoid nodule, pseudorheumatoid nodule, deep granuloma annulare, subcutaneous palisading granuloma, palisading granuloma nodosum, isolated subcutaneous nodule, isolated subcutaneous granuloma, necrobiotic granuloma
                                                • Definitions

                                                  • Benign inflammatory skin lesion of unknown etiology
                                                  • 4 clinically distinct subtypes
                                                    • Localized
                                                      • Most common type
                                                      • Nodular ringed skin eruption; typically on dorsum of hands, feet, forearms, legs, & thighs
                                                      • Children & young adults; 2/3 present < 30 years old
                                                    • Generalized
                                                      • Similar to localized form but more widespread
                                                      • Present < 10 or > 40 years of age
                                                    • Perforating
                                                      • Superficial lesion that perforates epidermis; evident on clinical exam
                                                    • Subcutaneous: Subtype of concern to radiologists
                                                      • Nonspecific nodular subcutaneous mass
                                                      • Almost exclusively seen in children

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Ultrasonographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. Fathi K et al: Subcutaneous granuloma annulare of the penis associated with a urethral anomaly: case report and review of the literature. Pediatr Dermatol. 31(4):e100-3, 2014
                                                                          2. Agrawal AK et al: An unusual presentation of subcutaneous granuloma annulare in association with juvenile-onset diabetes: case report and literature review. Pediatr Dermatol. 29(2):202-5, 2012
                                                                          3. Navarro OM: Soft tissue masses in children. Radiol Clin North Am. 49(6):1235-59, vi-vii, 2011
                                                                          4. Navarro OM et al: Pediatric soft-tissue tumors and pseudotumors: MR imaging features with pathologic correlation: part 1. Imaging approach, pseudotumors, vascular lesions, and adipocytic tumors. Radiographics. 29(3):887-906, 2009
                                                                          5. Grogg KL et al: Subcutaneous granuloma annulare in childhood: clinicopathologic features in 34 cases. Pediatrics. 107(3):E42, 2001
                                                                          6. Chung S et al: Subcutaneous granuloma annulare: MR imaging features in six children and literature review. Radiology. 210(3):845-9, 1999
                                                                          7. De Maeseneer M et al: Subcutaneous granuloma annulare: MR imaging findings. Skeletal Radiol. 27(4):215-7, 1998
                                                                          8. Kransdorf MJ et al: Subcutaneous granuloma annulare: radiologic appearance. Skeletal Radiol. 27(5):266-70, 1998
                                                                          9. Vandevenne JE et al: Subcutaneous granuloma annulare: MR imaging and literature review. Eur Radiol. 8(8):1363-5, 1998