Investigation for Mycobacterium in Cases of Granuloma

Document Type : Research Paper

Authors

1 Assistant professor of Dermatology, Emam Reza Hospital, Mashhad University of Medical Sciences,Mashhad, Iran

2 Associate Professor of Dermatology, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Associate Professor of Immunology, Mashhad University of Medical Sciences, Mashhad, Iran

4 Assistant professor of Microbiology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

5 Resident of Pathology, Emam Reza Hospital, Mashhad University of Medical Sciences,Mashhad, Iran

Abstract

Introduction
Granuloma Annulare (GA) is a granulomatous inflammatory lesion with unknown etiology. The etiologic relation between this disease and mycobacterium is still controversial. In this Descriptive-Cross sectional study, specimens of GA have been assessed for mycobacterium infection.
Materials and Methods
Paraffin embedded specimens of GA from archive of Pathology department of Emam Reza hospital, during 2001 to 2005, have been selected Multiplex PCR were done on them, with primers of 162bp and 123bp for mycobacterium in general and tuberculosis respectively.
Results
A total of 38 cases (31 female and 7 male) with the mean age of 42 years were found. The lesions were most commonly on upper extremities and the most common histological feature was lymphohistiocytic granulomatous inflammation of interstitial type (incomplete form of GA). With Zeil Nelson staining all cases were negative for acid fast bacilli. PCR In one case detected amplification of both 123 bp and 162 bp segments which were compatible with M. tuberculosis infection. This case had extensive lesions all over the upper extremities and back of the trunk and in histology it had a lot of giant cells which is not a usual finding in GA.
Conclusion
Mycobacterium may cause some types of GA lesions.

Keywords

References

1-Burns DA. Granuloma annulare. In: Burns T, Breathach, Cox N, Criffiths C. Rook,
s Textbook of dermatology. 7th ed .
London: Blackwell science; 2004.p.57.109-119.
2- Winkelmann RK. The grannuloma annulare phenotype and tuberculosis. J Am Acad dermatol 2002; 46:948-952.
3-Herron M, Florell S.Disseminated granuloma annulare accompanying mycobacterium tuberculosis lymphadenitis. Int
J Dermatol 2004; 43: 961-963.
4-Ferrara G, Connone M, Scalvenzi M, Delfino M, Staibano S, De Rosa G, et al. Facial granulomatous diseases: a
study of four cases tested for the presence of mycobacterium tuberculosis DNA using nested polymerase chain reaction.
Am J Dermatopathol 2001; 23: 8-15.
5- Barr LK, Lowe L,Su LD.Lyndon D.mycobacterium marinum infection simulating intersititial granuloma annulare a
report of two case annulare. Am J Dermatopathol 2003; 25:148-151.
6-Bartralot R, Pujol RM, Garcia–Patos V, Sitjas D, Martin–Casabona N, Coll P, et al. Cutaneous infections due to
nontuberculous mycobacteria: histopathological review of 28 cases. Comparative study between lesions observed ib
innunosuppressed patients and normal hosts. J Cutan Pathol 2000; 27:124-129.
7-Tsai T, Chen G-S, lan L-H, Lan E. Cutaneous tuberculid clinically resembling generalized granuloma annulare. Clin
Exp Dermatol 2007; 32:450-451.
8-Houcke–Bruge C, Delaporte E, Catteav B, Martin D, Lassoll E, Piette F. Gronuloma annulare following BCG
vaccination. Ann Dermatol Venereol 2001; 128:541-544.
9- Senturk N, Sahin S, Kocagoz T. Polymerase chain reaction in cutaneous tuberculasis: is it a reliable diagnostic
method in paraffin – embedded tissues. Int J Dermatol 2002; 41: 863-866.
10- Park D, Kim J, Choi K, Lee J, Lee C, Sol M, et al. Comparison of polymerase chain reaction with histopatologic
features for diagnosis of tuberculosis is formalin – fixed, paraffin – embedde of histologic specimens. Arch Pathol Lab
Med 2003; 127:326-330.
11- Yang B, Koga H, Ohno H, Ogawa K, Hossain MA, et al. Detection of mycobacterium tuberculosis in preserved
tuberculous lymph nodes by polymerase chain reaction. Tohoku J Exp Med 1998; 184:123-131. 
medical journal of mashhad university of medical sciences
Volume 52, Issue 3 - Serial Number 3
September and October 2008
Pages 151-156

Files

Share

How to cite

Statistics