Coexistence of Granuloma Annulare and Castleman’s Disease: A Case Report

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Lacey Falgout
Bonnie A Hodge
Tiffany T Mayo


granuloma annulare, castlemans disease, lymphoproliferative, interleukin 6, unicentric, multicentric


Granuloma annulare (GA) is a self-limited disorder that may present as localized or general. Localized GA, the most common form, presents as an erythematous annular plaque without scale. The generalized form of GA presents as widespread erythematous papules and plaques over the trunk and extremities. A cross-sectional study in the United States found a female to male prevalence ratio of 3:1 with a higher prevalence in the fifth decade of life.1 The etiology of GA is largely unknown; however, a number of potential inciting factors have been reported including viral infections, drug exposure, trauma, and insect bites.

Castleman’s Disease is a rare heterogenous lymphoproliferative disorder that encompasses a spectrum of clinicopathologic manifestations. Unicentric disease affects one lymph node or chain of lymph nodes with primarily hyaline vascular changes. The multicentric form affects multiple chains of lymph nodes with primarily plasmacytic changes. The pathogenesis is related to hypercytokinemia due to dysregulated interleukin-6 (IL-6) activity in unicentric disease and dysregulated IL-6 and human herpes virus-8 in multicentric disease.

We report a case of concomitant granuloma annulare and Castleman’s Disease.


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3. Dispenzieri A, Fajgenbaum DC. Overview of Castleman disease. Blood. 2020 Apr 16;135(16):1353-1364. doi: 10.1182/blood.2019000931. PMID: 32106302.

4. Min MS, Wu J, He H, et al. Granuloma annulare skin profile shows activation of T-helper cell type 1, T-helper cell type 2, and Janus kinase pathways. Journal of the American Academy of Dermatology. 2020;83(1):63-70. doi:10.1016/j.jaad.2019.12.028

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