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Granulomas of the Skin-Noninfectious
Paul K. Shitabata, M.D.Dermatopathology Institute
Thursday, May 23, 13
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Granulomas
Suppurative Caseating Non-caseating
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Collagenolytic Granulomas
Blue Red
Granuloma annulareWegener’s granulomatosisRheumatoid vasculitis
Necrobiosis lipoidicaNecrobiotic xanthogranulomaRheumatoid noduleChurg-Strauss syndromeWell’s syndrome
J Cutan Pathol 2004;31:353-361
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Sarcoidosis
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Histopathology
Naked non-caseating granulomas
Rare giant cells Rare asteroid bodies Stains negative Rule out tattoo
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Granuloma Annulare
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Histopathology
Superfical to deep perivascular and interstitial dermatitis
May have minimal collagen necrobiosis and mucin
Scattered giant cells
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Necrobiosis Lipoidica Diabeticorum
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Histopathology
Superficial and deep perivascular and periadnexal dermatitis
Staircase collagen necrobiosis
Scattered giant cells and plasma cells
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Churg-Strauss Syndrome
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Histopathology
Eosinophilic granulomas Necrobiosis with
increased eosinophils May have flame figures
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Foreign Body Reaction
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Histopathology
Foreign body type giant cells
Varying degrees of necrosis
Polarize and microbiological special stains
Rule out sarcoidosis
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