Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies: A case–control study

Aaron Mangold; Helen J.L. Cumsky; Collin M. Costello; Daniel Y. Xie; Matthew R. Buras; Steven A. Nelson; David J. DiCaudo; Aleksandar D Sekulic; Mark R. Pittelkow

doi:10.1016/j.jaad.2018.06.022

Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies: A case–control study

Aaron Mangold, Helen J.L. Cumsky, Collin M. Costello, Daniel Y. Xie, Matthew R. Buras, Steven A. Nelson, David J. DiCaudo, Aleksandar D Sekulic, Mark R. Pittelkow

Dermatology

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Background: Granuloma annulare (GA) is a granulomatous skin eruption rarely associated with cancer. We report seven cases of paraneoplastic GA in association with solid organ malignancy. Objective: To compare the clinical and histopathological features of paraneoplastic GA to case-matched controls of classic GA. Methods: Retrospective chart and histopathological review of 7 individuals and 13 age- and sex-matched controls. Paraneoplastic GA was defined as GA occurring within 6 months of the diagnosis of solid organ malignancy and/or persistent GA that resolved with cancer treatment. Results: Most cases of paraneoplastic GA were associated with lung cancer (4/7). The clinical and histopathological features of paraneoplastic and classic GA were similar. Compared to classic GA, paraneoplastic GA cases were more often generalized disease (6/7 vs 6/13), refractory to treatment, and had a perivascular inflammatory cell infiltrate (5/7 vs 2/13). All cases of paraneoplastic GA that underwent definitive treatment of their cancer improved. Limitations: Single-institution, retrospective review with a small sample size. Conclusion: Paraneoplastic GA is rare, similar to classic GA, and refractory to treatment. We advocate for age-appropriate screening in individuals with GA that is nonresponsive to multiple lines of systemic treatment and evaluating patients with concerning signs or symptoms for an underlying neoplasm.

Original language	English (US)
Journal	Journal of the American Academy of Dermatology
DOIs	https://doi.org/10.1016/j.jaad.2018.06.022
State	Accepted/In press - Jan 1 2018

Keywords

granuloma annulare
paraneoplastic
solid organ malignancy

ASJC Scopus subject areas

Dermatology

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10.1016/j.jaad.2018.06.022

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Mangold, A., Cumsky, H. J. L., Costello, C. M., Xie, D. Y., Buras, M. R., Nelson, S. A., DiCaudo, D. J., Sekulic, A. D., & Pittelkow, M. R. (Accepted/In press). Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies: A case–control study. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2018.06.022

Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies : A case–control study. / Mangold, Aaron; Cumsky, Helen J.L.; Costello, Collin M.; Xie, Daniel Y.; Buras, Matthew R.; Nelson, Steven A.; DiCaudo, David J.; Sekulic, Aleksandar D; Pittelkow, Mark R.

In: Journal of the American Academy of Dermatology, 01.01.2018.

Research output: Contribution to journal › Article › peer-review

Mangold, Aaron ; Cumsky, Helen J.L. ; Costello, Collin M. ; Xie, Daniel Y. ; Buras, Matthew R. ; Nelson, Steven A. ; DiCaudo, David J. ; Sekulic, Aleksandar D ; Pittelkow, Mark R. / Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies : A case–control study. In: Journal of the American Academy of Dermatology. 2018.

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title = "Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies: A case–control study",

abstract = "Background: Granuloma annulare (GA) is a granulomatous skin eruption rarely associated with cancer. We report seven cases of paraneoplastic GA in association with solid organ malignancy. Objective: To compare the clinical and histopathological features of paraneoplastic GA to case-matched controls of classic GA. Methods: Retrospective chart and histopathological review of 7 individuals and 13 age- and sex-matched controls. Paraneoplastic GA was defined as GA occurring within 6 months of the diagnosis of solid organ malignancy and/or persistent GA that resolved with cancer treatment. Results: Most cases of paraneoplastic GA were associated with lung cancer (4/7). The clinical and histopathological features of paraneoplastic and classic GA were similar. Compared to classic GA, paraneoplastic GA cases were more often generalized disease (6/7 vs 6/13), refractory to treatment, and had a perivascular inflammatory cell infiltrate (5/7 vs 2/13). All cases of paraneoplastic GA that underwent definitive treatment of their cancer improved. Limitations: Single-institution, retrospective review with a small sample size. Conclusion: Paraneoplastic GA is rare, similar to classic GA, and refractory to treatment. We advocate for age-appropriate screening in individuals with GA that is nonresponsive to multiple lines of systemic treatment and evaluating patients with concerning signs or symptoms for an underlying neoplasm.",

keywords = "granuloma annulare, paraneoplastic, solid organ malignancy",

author = "Aaron Mangold and Cumsky, {Helen J.L.} and Costello, {Collin M.} and Xie, {Daniel Y.} and Buras, {Matthew R.} and Nelson, {Steven A.} and DiCaudo, {David J.} and Sekulic, {Aleksandar D} and Pittelkow, {Mark R.}",

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AU - Costello, Collin M.

AU - Xie, Daniel Y.

AU - Buras, Matthew R.

AU - Nelson, Steven A.

AU - DiCaudo, David J.

AU - Sekulic, Aleksandar D

AU - Pittelkow, Mark R.

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N2 - Background: Granuloma annulare (GA) is a granulomatous skin eruption rarely associated with cancer. We report seven cases of paraneoplastic GA in association with solid organ malignancy. Objective: To compare the clinical and histopathological features of paraneoplastic GA to case-matched controls of classic GA. Methods: Retrospective chart and histopathological review of 7 individuals and 13 age- and sex-matched controls. Paraneoplastic GA was defined as GA occurring within 6 months of the diagnosis of solid organ malignancy and/or persistent GA that resolved with cancer treatment. Results: Most cases of paraneoplastic GA were associated with lung cancer (4/7). The clinical and histopathological features of paraneoplastic and classic GA were similar. Compared to classic GA, paraneoplastic GA cases were more often generalized disease (6/7 vs 6/13), refractory to treatment, and had a perivascular inflammatory cell infiltrate (5/7 vs 2/13). All cases of paraneoplastic GA that underwent definitive treatment of their cancer improved. Limitations: Single-institution, retrospective review with a small sample size. Conclusion: Paraneoplastic GA is rare, similar to classic GA, and refractory to treatment. We advocate for age-appropriate screening in individuals with GA that is nonresponsive to multiple lines of systemic treatment and evaluating patients with concerning signs or symptoms for an underlying neoplasm.

AB - Background: Granuloma annulare (GA) is a granulomatous skin eruption rarely associated with cancer. We report seven cases of paraneoplastic GA in association with solid organ malignancy. Objective: To compare the clinical and histopathological features of paraneoplastic GA to case-matched controls of classic GA. Methods: Retrospective chart and histopathological review of 7 individuals and 13 age- and sex-matched controls. Paraneoplastic GA was defined as GA occurring within 6 months of the diagnosis of solid organ malignancy and/or persistent GA that resolved with cancer treatment. Results: Most cases of paraneoplastic GA were associated with lung cancer (4/7). The clinical and histopathological features of paraneoplastic and classic GA were similar. Compared to classic GA, paraneoplastic GA cases were more often generalized disease (6/7 vs 6/13), refractory to treatment, and had a perivascular inflammatory cell infiltrate (5/7 vs 2/13). All cases of paraneoplastic GA that underwent definitive treatment of their cancer improved. Limitations: Single-institution, retrospective review with a small sample size. Conclusion: Paraneoplastic GA is rare, similar to classic GA, and refractory to treatment. We advocate for age-appropriate screening in individuals with GA that is nonresponsive to multiple lines of systemic treatment and evaluating patients with concerning signs or symptoms for an underlying neoplasm.

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