Резюме
Определение
History and exam
Key diagnostic factors
- бессимптомные сгруппированные аннулярные дермальные папулы розового или телесного цвета
Other diagnostic factors
- телесного цвета, розовый или коричневый macules или небольшие папулы
- узлы в мягких тканях
- перфорирующие папулы, корочки или язвенные поражения
- эритематозные пятна
Risk factors
- сахарный диабет
- Злокачественное заболевание крови
- опоясывающий лишай
- ВИЧ
- гепатит
- гиперлипидемия
- заболевания щитовидной железы
- лекарственные препараты
Diagnostic investigations
1st investigations to order
- клинический диагноз
Investigations to consider
- биопсия кожи
- уровень сахара в крови натощак
- исследование функции щитовидной железы
- скрининг липидов
- скрининг гепатита
- исследование на ВИЧ
Treatment algorithm
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
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.
Differentials
- Кольцевидный плоский лишай
- Дерматофитные инфекции
- Грибковый микоз
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