Spectrum and clinical variants of giant cell elastolytic granuloma

Abstract

Background

Giant cell elastolytic granuloma, also known as annular elastolytic giant cell granuloma or actinic granuloma, is histologically characterized by elastophagocytosis. Recent studies have revealed various clinical presentations in both sun-exposed and non-sun-exposed areas.

Objectives

To clarify clinical characteristics based on case series observation.

Methods

We retrospectively reviewed patients who fulfilled the pathological diagnosis criteria for giant cell elastolytic granuloma seen at Mackay Memorial Hospital from 2000 to 2014. Patient characteristics, clinical presentation, duration, associated diseases, treatment, and prognosis were analyzed.

Results

A total of 22 patients were analyzed and categorized into three major variants. Eight patients with the "annular form" showed large annular lesions, which were usually associated with sun exposure. Six patients with the "papular form" presented with small papules. Eight patients in the "mixed form" group exhibited both papules and smaller annular plaques. The papular form had the youngest age of onset and shortest disease duration. The known consequences in 19 patients were resolved in seven, improved in three, recurred in four, and persisted in five patients.

Conclusions

The term "giant cell elastolytic granuloma" is more appropriate because these were not completely related to actinic changes and may be nonannular. The papular form is not easily recognizable without a biopsy.

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