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The first 25 slides, exactly as they appear. The full deck has 168 content slides.
Dermatology
Non-infectious Granulomas
Built from Dermatology, 5th Edition
What’s inside
8 sections · 168 slides
Overview
- What this topic covers
- What is a granuloma
- Five entities, one shared reaction pattern
- Diagnostic algorithm for non-infectious granulomas
- Comparing the major entities at a glance
- Clinical features of the major non-infectious granulomatous dermatitides
- Clinical features of the major non-infectious granulomatous dermatitides (continued)
- Clinical features of the major non-infectious granulomatous dermatitides (continued)
- Clinical features of the major non-infectious granulomatous dermatitides (continued)
- Clinical features of the major non-infectious granulomatous dermatitides (continued)
Sarcoidosis
A whole-body granulomatous disease that often shows itself in the skin
- Key features
- Named subsets of sarcoidosis
- History
- Who gets sarcoidosis
- 107/100k
- How the immune system overreacts
- How a sarcoid granuloma forms
- Anergy: the immune system looks weak, locally
- Searching for a trigger
- Drug-triggered sarcoidosis
- Genetics
- Where skin lesions appear
- Papules and plaques of cutaneous sarcoidosis
- Sarcoidosis favoring the nasal rim
- Linear sarcoidosis lesions on the neck
- Sarcoidosis plaque on the forehead
- Sarcoidosis papules arising within a tattoo
- Unusual clinical variants
- Hypopigmented, ichthyosiform, and lupus pernio variants
- Hypopigmented annular sarcoidosis
- Lupus pernio
- Angiolupoid sarcoidosis
- The diascopy sign
- Erythema nodosum and Lofgren syndrome
- Nails, mouth, and Heerfordt syndrome
- Sarcoidosis is a whole-body disease
- Organs sarcoidosis can involve
- Systemic manifestations of sarcoidosis
- Systemic manifestations of sarcoidosis (continued)
- Systemic manifestations of sarcoidosis (continued)
- Systemic manifestations of sarcoidosis (continued) (continued)
- Systemic manifestations of sarcoidosis (continued) (continued)
- Systemic manifestations of sarcoidosis (continued) (continued)
- Sarcoidosis in children
- Naked tubercles: the histologic hallmark
- Sarcoidal granulomas: naked tubercles
- Giant cells with special inclusions
- Confirming the diagnosis
- Ruling out infection first
- Foreign material and other look-alikes
- Histologic features across the granulomatous diseases
- Immune checkpoint inhibitor-induced sarcoidosis
- Another case of checkpoint-inhibitor sarcoidosis
- How varied cutaneous sarcoidosis can look
- Spectrum of cutaneous manifestations of sarcoidosis
- Spectrum of cutaneous manifestations of sarcoidosis (continued)
- First-line treatment
- Steroid-sparing options
- Newer and alternative options
- Treatment of cutaneous sarcoidosis
Granuloma Annulare
Ring-shaped papules and plaques, plus its sun-related cousin AEGCG
- Key features
- History
- Who gets granuloma annulare
- An unknown trigger
- AEGCG: a possible sun-damage reaction
- The classic look of GA
- Granuloma annulare: annular plaques on hands and feet
- Generalized (disseminated) GA
- Figurate granuloma annulare on the arm
- Granuloma annulare with elevated papular rims
- Granuloma annulare in a patient with diabetes
- Arciform granuloma annulare on the back
- Figurate granuloma annulare plaques
- Generalized granuloma annulare
- Widespread papules and small plaques of generalized GA
- Generalized granuloma annulare in a child
- Generalized granuloma annulare with midline confluence
- Generalized granuloma annulare: back and legs
- Subcutaneous (deep) GA
- Perforating and patch GA
- Less common variants of granuloma annulare
- Patch and subcutaneous granuloma annulare in children
- AEGCG: a sun-related variant
- Annular elastolytic giant cell granuloma: clinical appearance
- AEGCG: a second clinical example
- Annular elastolytic giant cell granuloma on the trunk
- Disease associations and look-alikes
- Classification of granuloma annulare
- What GA looks like under the microscope
- Granuloma annulare: interstitial histologic pattern
- Granuloma annulare: palisading granuloma pattern
- AEGCG under the microscope
- Elastophagocytosis in AEGCG
- AEGCG: giant cells and elastophagocytosis
- Elastic tissue stain in AEGCG
- Elastic tissue loss: a second example
- Differential diagnosis
- First steps: local therapy
- Widespread disease
- Treatment ladder for granuloma annulare
- Treatment of granuloma annulare
- Natural history
Necrobiosis Lipoidica
Yellow-brown atrophic plaques on the shins, often linked to diabetes
- Key features
- History
- Who gets necrobiosis lipoidica
- 65%
- What might be going on
- The classic look
- Necrobiosis lipoidica: range of clinical appearance
- Necrobiosis lipoidica on the shin
- Necrobiosis lipoidica with annular telangiectatic plaques
- Sensation and symptoms
- Under the microscope
- Necrobiosis lipoidica: histologic features
- Differential diagnosis
- Treatment: local measures first
- Treatment: wider options
Cutaneous Crohn Disease
Granulomatous inflammation of the skin, genitals, and mouth in Crohn disease
- Key features
- History and epidemiology
- Four types of skin change in Crohn disease
- Genes and immune pathways
- Genital and anal disease
- Mucocutaneous Crohn disease: cutaneous and oral findings
- Penile lymphedema in cutaneous Crohn disease
- Labial swelling in a child with cutaneous Crohn disease
- Oral and non-genital skin disease
- Under the microscope
- Differential diagnosis
- Treatment
Two Related Entities
Foreign body granulomas and orofacial granulomatosis, in brief
- Foreign body granulomas
- Orofacial granulomatosis (OFG)
Reactive Granulomatous Dermatitis
A shared pattern linking IGD, PNGD, and drug-induced granulomatous reactions
- Key features
- History
- How the reaction starts
- Why it happens where it does
- PNGD vs. IGD: two ends of one spectrum
- Reactive granulomatous dermatitis: annular plaques and the rope sign
- Large patch resembling patch-type granuloma annulare
- Drug-induced granulomatous dermatitis
- Which drugs are most often blamed
- Interstitial granulomatous drug reaction: associated medications and supplements
- Under the microscope
- Reactive granulomatous dermatitis: histologic features
- Differential diagnosis
- Related patterns in rheumatologic disease
- Spectrum of granulomatous, neutrophilic, and vasculitic dermatoses in rheumatologic disorders
- Treatment
Putting It Together
How to tell these granulomatous diseases apart at the bedside
- Quick clinical clues
- Quick pathology clues
- What ties this whole chapter together
- References
- References (continued 2/17)
- References (continued 3/17)
- References (continued 4/17)
- References (continued 5/17)
- References (continued 6/17)
- References (continued 7/17)
- References (continued 8/17)
- References (continued 9/17)
- References (continued 10/17)
- References (continued 11/17)
- References (continued 12/17)
- References (continued 13/17)
- References (continued 14/17)
- References (continued 15/17)
- References (continued 16/17)
- References (continued 17/17)
- Dermatology, 5th Edition (2-Volume Set)