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Granulomatosis disciformis chronica et progressivaL92.1

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 14.06.2022

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Synonym(s)

facial necrobiosis Miserable; Granulomatosis pseudosclerodermiformis symmetrica chronica (Gottron); Granulomatosis tuberculoides pseudosclerodermiformis; macular necrobiosis; Miescher Granulomatosis; Miescher`s granulomatosis; necrobiosis lipoidica granulomatosa

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HistoryThis section has been translated automatically.

Gottron, 1935; Miescher and Lederer, 1948

DefinitionThis section has been translated automatically.

Controversial and apparently rare, chronic, granulomatous (non-necrobiotic) disease whose entity is controversially discussed. An affiliation to necrobiosis lipoidica is often assumed (minus variant of necrobiosis lipoidica).

EtiopathogenesisThis section has been translated automatically.

Unknown, trauma, a diabetic metabolic state is not always present in this sepcific granulomatosis (Oliveira ARFM et al. 2017).

ManifestationThis section has been translated automatically.

Middle adulthood; predominantly in women (note: the clinical data available in the literature are insufficient in this respect).

LocalizationThis section has been translated automatically.

Mainly lower leg extension sides, back of the foot, but also described in the face and neck.

Clinical featuresThis section has been translated automatically.

Slowly centrifugally growing, 1.0-10.0 cm in size, asymptomatic, flatly raised or barely palpable, bizarrely configured, reddish-brown or light brown plaques (or spots) with partly yellowish parts; telangiectasia, atrophic surface; tendency to confluence.

HistologyThis section has been translated automatically.

Perivascular epithelial cell granulomas with few giant cells. In contrast to Necrobiosis lipoidica, there are hardly any necrobiosis foci.

Differential diagnosisThis section has been translated automatically.

Necrobiosis lipoidica; granuloma anulare; sarcoidosis; circumscribed scleroderma.

External therapyThis section has been translated automatically.

Glucocorticoid-containing external preparations (e.g. 0.1% triamcinolone cream R259 or 0.1% betamethasone ointment) and foil dressings, injection of glucocorticoid crystal suspension intrafocally (e.g. Volon A 10 mg, 1:3-1:5 diluted with the local anaesthetic scandicain). For small foci excision.

Progression/forecastThis section has been translated automatically.

Mostly chronic progressive course; very rarely spontaneous healing.

LiteratureThis section has been translated automatically.

  1. Almond-Roesler B et al (1998) Granulomatosis disciformis Miescher. dermatologist 49: 228-230
  2. Bergler-Czop B et al (2009) Miescher's granulomatosis (granulomatosis disciformis chronica et progressiva) in a non-diabetic patient-case report. Diagn Pathol 4:28
  3. Gottron HA (1935) Granulomatosis (tuberculoides) pseudosclerodermiformis symmetrica chronica. Arch Dermatol Syph 172: 142
  4. Miescher G, Lederer M (1948) Granulomatosis disciformis chronica et progressiva (atypical tuberculosis). Dermatologica (Basel) 97: 25-34
  5. Miescher G (1949) Necrobiosis maculosa. Dermatologica (Basel) 98: 199-204
  6. Oliveira ARFM et al (2017) Granulomatosis disciformis in a non-diabetic patient. On Bras Dermatol 92:438-439.

Authors

Last updated on: 14.06.2022

Author: Prof. Dr. med. Peter Altmeyer