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Кольцевидная гранулема

Последний просмотренный: 21 Sep 2025
Last updated: 26 Nov 2020

Резюме

Определение

History and exam

Key diagnostic factors

  • бессимптомные сгруппированные аннулярные дермальные папулы розового или телесного цвета
Full details

Other diagnostic factors

  • телесного цвета, розовый или коричневый macules или небольшие папулы
  • узлы в мягких тканях
  • перфорирующие папулы, корочки или язвенные поражения
  • эритематозные пятна
Full details

Risk factors

  • сахарный диабет
  • Злокачественное заболевание крови
  • опоясывающий лишай
  • ВИЧ
  • гепатит
  • гиперлипидемия
  • заболевания щитовидной железы
  • лекарственные препараты
Full details

Diagnostic investigations

1st investigations to order

  • клинический диагноз
Full details

Investigations to consider

  • биопсия кожи
  • уровень сахара в крови натощак
  • исследование функции щитовидной железы
  • скрининг липидов
  • скрининг гепатита
  • исследование на ВИЧ
Full details

Treatment algorithm

ACUTE

локализованная форма (классическая кольцевая сыпь)

генерализованная форма (распространенная макулярная сыпь)

перфорирующая форма (корочки или язвенные поражения)

подкожная форма (мягкий узелок)

пятнистая форма (эритематозные бляшки)

Contributors

Authors

Misha Rosenbach, MD

Associate Professor

Dermatology and Internal Medicine

University of Pennsylvania

Philadelphia

PA

Disclosures

MR has received consulting fees from Merck, aTyr Pharma, and Processa Pharma, not related to granuloma annulare. He has received grant support from Processa Pharma, not related to granuloma annulare. MR has received salary support from the AMA/JAMA for his role at JAMA Dermatology as Deputy Editor. MR is an author of references cited in this topic.

Acknowledgements

Dr Misha Rosenbach would like to gratefully acknowledge Dr Susmita Mukherjee, a previous contributor to this topic. SM declares that she has no competing interests.

Peer reviewers

Aisha Sethi, MD

Assistant Professor of Medicine

Associate Residency Program Director

University of Chicago

Chicago

IL

Disclosures

AS declares that she has no competing interests.

Robert Herd, MSc, MD, FRCP

Consultant Dermatologist

Department of Dermatology

Nuffield Hospital

Glasgow

UK

Disclosures

RH declares that he has no competing interests.

Brenda L. Pellicane, MD

Dermatologist

Wayne State University School of Medicine

Department of Dermatology

Detroit

MI

Disclosures

BLP declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Piette EW, Rosenbach M. Granuloma annulare: clinical and histologic variants, epidemiology, and genetics. J Am Acad Dermatol. 2016 Sep;75(3):457-65. Abstract

Thornsberry LA, English JC 3rd. Etiology, diagnosis, and therapeutic management of granuloma annulare: an update. Am J Clin Dermatol. 2013 Aug;14(4):279-90. Abstract

Piette EW, Rosenbach M. Granuloma annulare: pathogenesis, disease associations and triggers, and therapeutic options. J Am Acad Dermatol. 2016 Sep;75(3):467-79. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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