What are the other Names for this Condition? (Also known as/Synonyms)

• Reactive Granulomatous Dermatitis (RGD)
• RGD (Reactive Granulomatous Dermatitis)

What is Granulomatous Dermatitis? (Definition/Background Information)

• Granulomatous Dermatitis or Reactive Granulomatous Dermatitis (RGD) forms a group of heterogenous conditions involving skin that develop in the background of an associated disease/disorder or other factors. Thus, Granulomatous Dermatitis may be broadly described as cutaneous manifestations of systemic conditions
• Based on their association and histological characteristic (following analysis of a skin tissue biopsy by the pathologist under a microscope), the following conditions are included:
  • Granuloma annulare (GA) - it is a common skin condition that occurs as a skin rash
  • Interstitial granulomatous dermatitis (IGD) - it is commonly associated with autoimmune disorders
  • Palisading neutrophilic granulomatous dermatitis (PNGD) - it is observed in the background of systemic disorders
  • Interstitial granulomatous drug reaction (IGDR) - it develops as a reaction to the use of certain medications, commonly antihypertensives
  • Non-caseating granuloma (non-necrotizing granuloma)
  • Sarcoid-like granuloma
• The treatment of Granulomatous Dermatitis is based on the signs and symptoms, which may wax and wane, and associated condition. With adequate treatment of the associated condition, Granulomatous Dermatitis may improve or resolve completely. However, the long-term outcomes depend on the severity of the underlying/associated condition

Who gets Granulomatous Dermatitis? (Age and Sex Distribution)

• Granulomatous Dermatitis may be observed in children and adults of a wide age range
• Both males and females are known to be affected
• The condition may affect individuals of all racial and ethnic groups

What are the Risk Factors for Granulomatous Dermatitis? (Predisposing Factors)

A wide variety of conditions have been associated with Granulomatous Dermatitis. The associations depend on the specific type of Granulomatous Dermatitis and may include:

• Autoimmune diseases
• Certain medications
• Diabetes
• Infections
• Lymphoproliferative disorders
• Malignancies
• Systemic vasculitis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Granulomatous Dermatitis? (Etiology)

Presently, the cause of formation of Granulomatous Dermatitis is unknown. The granulomatous lesions are believed to develop as a reactive process of the body to certain antigens in the body.

What are the Signs and Symptoms of Granulomatous Dermatitis?

The signs and symptoms of Granulomatous Dermatitis may be mild or severe and may depend on the associated condition. The signs and symptoms may vary widely from one individual to another, and may include:

• Presence of numerous papules, plaques, vesicles, and nodules that may be focal or generalized
• These granulomatous skin lesions may range in color from buff-colored to pink to red
• The lesions may be located anywhere in the body such as the trunk, upper and lower limbs, face and neck, etc.
• The size and shape of the rashes may be linear, annular, circular, or irregular
• The lesions may be associated with pain, itching, and burning sensation
• The skin lesions may be present for several days to months; a waxing and waning of the lesions may be noted

Additional signs and symptoms of the associated disorder, if any present, may be noted.

How is Granulomatous Dermatitis Diagnosed?

The following tests and exams may be used in diagnosing Granulomatous Dermatitis:

• Evaluating the clinical history (physical exam) and a thorough family history
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• KOH tests to rule out a fungal infection
• Skin tissue biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Tests and procedures to diagnose the associated condition, if any present, is important.

A differential diagnosis to eliminate other skin conditions may be needed before arriving at a definitive diagnosis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Granulomatous Dermatitis?

The complications of Granulomatous Dermatitis are not very significant, but may include the following:

• Emotional stress
• Cosmetic concerns
• Relapse or recurrence of the condition
• Treatment complications

Complications of the underlying/associated condition, if any, may be noted.

How is Granulomatous Dermatitis Treated?

The treatment of Granulomatous Dermatitis primarily involves managing the underlying/associated condition. Based on the healthcare provider’s evaluation, a symptomatic treatment of the skin signs and symptoms may be undertaken via the following measures:

• Use of topical steroid creams and ointments
• Oral and systemic steroids, if necessary
• Administration of medications such as dapsone, hydroxychloroquine, and methotrexate

How can Granulomatous Dermatitis be Prevented?

Currently, there are no specific preventative measures available for Granulomatous Dermatitis.

• Adequately treating any underlying disease/disorder/infection may lower one’s risk
• Medication that cause the skin condition as a side effect may be discontinued and/or alternative medication prescribed

What is the Prognosis of Granulomatous Dermatitis? (Outcomes/Resolutions)

Granulomatous Dermatitis may improve or resolve with adequate treatment of the associated disorder. However, the overall prognosis is dependent upon the severity of the associated disorder.

Additional and Relevant Useful Information for Granulomatous Dermatitis:

Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition.