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June 29, 2021
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Granuloma annulare associated with diabetes, hyperlipidemia

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Diabetes and hyperlipidemia are both associated with granuloma annulare and may be risk factors for its development, according to a study.

“Granuloma annulare (GA) is characterized by ringed, erythematous plaques. Most patients have localized disease, but 15% to 25% will have more generalized skin lesions, and subcutaneous variants have also been described,” John S. Barbieri, MD, MBA, of the department of dermatology at the University of Pennsylvania Perelman School of Medicine, and colleagues wrote. “Although GA may occur as an isolated disease limited to the skin, several potential associations have been described, including diabetes and hyperlipidemia, autoimmune conditions such as thyroid disease and hematologic malignant neoplasms.”

A retrospective cohort study identified 5,137 patients with GA who were matched by age and sex with up to 10 randomly selected controls with a either a nevus or seborrheic keratosis.

Baseline diabetes was found in 21.1% of those with GA compared with 13.3% of controls (aOR = 1.67; 95% CI, 1.55-1.80). Incident diabetes was also more likely in those with GA (2.8% vs. 2.1%; aOR = 1.31; 95% CI, 1.10-1.57).

Baseline hyperlipidemia was found in 32.5% of the GA cohort compared with 28.4% of the control cohort (aOR = 1.15; 95% CU, 1.08-1.23).

In addition, patients with GA were more likely to have baseline hyperthyroidism (14.2% vs. 11.3%; aOR = 1.24; 95% CI, 1.15-1.36), baseline rheumatoid arthritis (1.2% vs. 0.9%; aOR = 1.34; 95% CI, 1.02-1.75), incident hypothyroidism (0.8% vs. 0.5%; aOR = 1.59; 95% CI, 1.14-2.22), incident systemic lupus erythematosus (0.4% vs. 0.1%; aOR = 3.06; 95% CI, 1.86-5.01) and incident rheumatoid arthritis (0.5% vs. 0.2%; aOR = 2.05; 95% CI, 1.34-3.13).

Baseline systemic lupus erythematosus was not associated with GA.

“These findings suggest that diabetes and hyperlipidemia may be risk factors for the development of GA and that autoimmunity may be an important factor in the pathogenesis of GA,” the authors wrote.