Keratoacanthomatous Changes: Unifying the Histologic Spectrum of Actinic Granuloma. (October 2018)

• Record Type: Journal Article
• Authors: Harb, Jennifer N.; Kalen, Jessica E.; Hsu, Sylvia; Diwan, Abdul Hafeez; Calame, Antoanella; Motaparthi, Kiran
• Is Part Of: American journal of dermatopathology. Volume 40:Number 10(2018)
• Publication Date: 2018-10
• Subjects: actinic granuloma -- annular elastolytic giant-cell granuloma -- O'Brien's granuloma; Skin -- Diseases -- Periodicals; Histology, Pathological -- Periodicals; 616.50705
• DOI: 10.1097/DAD.0000000000001156
• Languages: English
• ISSNs: 0193-1091

Abstract

Abstract : Abstract: Actinic granuloma (AG) manifests as annular plaques on sun-damaged skin. There remains no universal consensus on the nosology, etiology, or clinicopathologic criteria of AG as a distinct entity. Broadly, AG is characterized by granulomatous inflammation, multinucleated giant cells, elastophagocytosis, and the absence of mucin and necrobiosis. It is not uncommon, however, to encounter overlapping histological features of other granulomas, such as granuloma annulare and necrobiosis lipoidica, confounding the diagnosis of this controversial entity. Herein, we describe 2 cases of AG with features of granuloma annulare and necrobiosis lipoidica, supporting the concept of AG as a histologic spectrum. These 2 cases displayed dilated follicular infundibula and pseudoepitheliomatous hyperplasia analogous to changes in keratoacanthomas. These unique epithelial changes, in tandem with characteristic elastin alterations and clinical findings, are helpful and unifying features that permit accurate diagnosis of this controversial entity.