Granulomas of the Skin-Noninfectious

Paul K. Shitabata, M.D.Dermatopathology Institute

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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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