Case 1

A 5-month-old male infant presented with a month-long history of gradually spreading erythema­tous papules on his trunk, upper and lower extremities. Skin examination revealed multiple, well-demarcated, erythematous, 1- to 5-mm-sized, and firm papules on his chest, abdomen, and both arms and legs (Fig. 1). Most of the papules were diffusely scattered. In the laboratory study, the results of complete blood cell count, blood chemistry, and urinalysis were within normal limits. A skin biopsy specimen, taken from the papule on the abdomen, revealed an infiltration of histiocytes, lymphocytes, and multinucleated giant cells around a zone of collagen alteration in upper and mid dermis (Fig. 2A). Mucin was demonstrated within degenera­tive collagen bundles by alcian blue stain at pH 2.5

fig.1. multiple

Fig. 1. Multiple 1- to 5-mm-sized erythematous pa­pules on trunk of male patient.

After he was treated with oral methylprednisolone 0.5 mg/kg/day for 10 days and topical corticosteroid (Dermatop® oint) for a month, the lesions dis­appeared leaving hyperpigmentation.
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fig.2. a central

Fig. 2. (A) A central area of altered collagen is surrounded by palisading of histiocytes, lymphocytes, and multinucleated giant cells (H&E stain, x 100). (B) mucin was demonstrated within degenerative collagen bundles

Case 2

A 3-month-old male infant presented with a 3-week history of generalized papules. Multiple erythematous papules were diffusely scattered on his face, chest, abdomen, and both amis and legs. Some of which were surrounded by erythema (Fig. 3). The laboratory study was not performed. A skin biopsy specimen taken from the papule on the abdomen revealed an infiltration of histiocytes around and between altered collagen fibers in upper and mid dermis (Fig. 4A). The collagen fibers were separated by mucin, which was positively stained with alcian blue at PH 2.5 (Fig. 4B).

fig.3. multiple

Fig. 3. Multiple erythematous papules were diffusely

After he was treated with topical corticosteroid (Lacticare-Zemagis® lotion) for a month, the lesions disappeared leaving hyperpigmentation. canada viagra online

fig.4. a a skin

Fig. 4. (A) A skin biopsy specimen revealed that histiocytes were infiltrated around and between altered collagen fibers in upper and mid dermis (H &E stain, x 100). (B) the altered collagen fibers were separated by mucin (alcian blue stain at pH 2.5

Category: Diseases / Tags: Generalized granuloma annulare, Infants

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