Hidetoshi Takahashi1*, Katsuhiko Satoh1, Akiyoshi Takagi1, Akemi Ishida-Yamamoto2 and Hajime Iizuka3
1Takagi Dermatological Clinic, Japan
2Department of Dermatology, Asahikawa Medical University, Japan
3Department of Dermatology, Housui Medical Center, Japan
Received: 03 August, 2015;Accepted: 17 August, 2015; Published: 24 August, 2015
Hidetoshi Takahashi, Takagi Dermatological Clinic, Nishi 3 minami 4-16, Obihiro, Hokkaido 0800013, Japan, Tel: +81-155-25-6733; Fax: +81-155-25-0308; E-mail:
Takahashi H, Satoh K, Takagi A, Ishida-Yamamoto A, Iizuka H (2015) Successful Treatment of Annular Elastolytic Giant Cell Granuloma with Tranilast and Topical Glucocorticoid under the Strict Restriction of Sun Exposure. Int J Dermatol Clin Res 1(2): 014-015. DOI: 10.17352/2455-8605.000006
© 2015 Takahashi H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Annular elastolytic giant cell granuloma; Glucocorticoids; Sunscreen; Tranilast; Treatment
AEGCG: Annular Elastolytic Giant Cell Granuloma
Annular elastolylic giant cell granuloma (AEGCG) is a rare granulomatous skin disease characterized by loss of elastic fibers accompanied with elastophagocytosis by multinucleated giant cells. The clinical appearance shows annular and serpiginous plaques with hypopigmentation or skin atrophy. Ultraviolet irradiation, heat, or other unknown factors are supposed to induce pathogenic alternation . The treatment for AEGCG remains unestablished and various therapeutic modalities including intralesional and systemic glucocorticoids, psoralen plus ultraviolet A irradiation, cryotherapy, retinoids, fumaric acid esters, pimecrolimus and minocycline are applied [2,3]. We report a case of AEGCG successfully treated with oral tranilast and topical glucocorticoid with sunscreens.
A 62-year-old Japanese man was referred to our clinic, because of gradually enlarging asymptomatic reddish annular plaques with raised border on right dorsal hand and neck (Figures 1a,b). No other skin or mucosal lesions were detected. Histopathological examination revealed non-palisading granulomas in the upper and mid dermis with multinucleated giant cells showing elastophagocytosis (Figure 1c). Elastica van Gieson staining confirmed reduced elastic fibers and elastophagocytosis by multinucleated giant cells (Figure 1d). Laboratory analyses, blood cell count, biochemical tests, serum levels of blood glucose, haemoglobin A1c, and angiotensin-converting enzyme were within normal limits. These clinical and histopathlogical findings led to a diagnosis of AEGCG. The patient was advised to use sunscreens and was treated with topical 0.05% betamethasone butyrate propionate ointment and oral tranilast at 300 mg/day for 10 weeks. The lesions gradually improved in two months (Figures 1e,f).
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