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Clinical and histologic presentation of pediatric reactive granulomatous dermatitis
Author(s) -
Akinshemoyin Vaughn Olushola L.,
Siegel Dawn H.,
Chiu Yvonne E.,
DeBord Logan C.,
Hogeling Marcia,
Hunt Raegan D.,
Nguyen Cordellia,
Sokumbi Olayemi,
Verbsky James W.,
Arkin Lisa M.
Publication year - 2020
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.14137
Subject(s) - medicine , histiocyte , pathology , dermatology , biopsy , skin biopsy , presentation (obstetrics) , surgery
Objective To characterize the clinical and histologic presentation of reactive granulomatous dermatitis (RGD) in the pediatric population. Methods In this multicenter retrospective chart review, 7 pediatric patients with biopsy‐proven RGD were identified. Photographs, histology reports, and clinical course were reviewed to discover patterns in demographics, comorbid conditions, autoimmune sequelae, drug exposures, infections, morphology, and histologic features. Results Overall, 7 patients were included and analyzed. Most were female and Hispanic. All presented with a similar dermatologic phenotype previously described in the adult literature including macular erythema and annular, pink to violaceous, edematous papules and plaques, often involving proximal extremities and extensor joints. All biopsies demonstrated variable collagen alteration and a perivascular interstitial infiltrate of histiocytes with or without mucin. Neutrophils or karyorrhexic debris were present in 4/7 of the biopsies, and eosinophils were occasionally seen (2/7 cases). In all cases, RGD was associated with active SLE or led to a new diagnosis, and initiation of systemic treatment improved cutaneous disease. Conclusions Pediatric RGD was more common in female patients and ethnic minorities, and strongly associated with SLE. Clinical and histologic presentations were consistent across all cases with only minor variations, suggesting that recognition and confirmation might be expedited by familiarity with these dominant patterns. Diagnosis of RGD in pediatric patients should prompt screening for SLE.