中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (6): 416-419.doi: 10.12144/zgmfskin202506416

• 论著 • 上一篇    下一篇

279例环状肉芽肿临床病理分析

张帆1,2,周桂芝1,2,刘永霞1,2,张雪燕1,2,陈声利1,2   

  1. 1山东第一医科大学附属皮肤病医院，山东济南，250022； 2山东省皮肤病性病防治研究所，山东济南，250022
  • 出版日期:2025-06-15 发布日期:2025-05-21

Clinical and pathological analysis of 279 cases of granuloma annulare

ZHANG Fan1,2, ZHOU Guizhi1,2, LIU Yongxia1,2, ZHANG Xueyan1,2, CHEN Shengli1,2   

  1. 1 Dermatology Hospital of Shandong First Medical University, Jinan 250022, China; 2 Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan 250022, China
  • Online:2025-06-15 Published:2025-05-21

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摘要： 目的：总结环状肉芽肿的临床特征、组织病理学特点及其误诊情况，为临床诊断提供参考。方法：回顾性分析2018年12月至2024年7月我院279例病理诊断为环状肉芽肿患者的临床资料和组织病理学表现。分析患者的年龄、性别、病变部位、临床分型、组织病理学类型及误诊率。结果：279例患者，男女性别比为3∶4，平均年龄48.8岁，中老年人（40岁以上）占78.85%。临床分型中局限型231例，泛发型43例，穿通型3例，皮下型2例。组织病理分型中栅栏状环状肉芽肿216例，间质型30例，皮下型27例，穿通型6例。279例患者中99例(35%)被误诊，误诊为湿疹/特应性皮炎最多（18例）。结论：环状肉芽肿临床误诊率高，在中老年人中多发，临床以局限型多见，组织病理以栅栏状肉芽肿为主。

关键词: 环状肉芽肿, 临床特征, 组织病理, 鉴别诊断

Abstract: Objective: To summarize the clinical features, histopathological characteristics, and misdiagnosis situations of granuloma annulare, providing references for clinical diagnosis. Methods: A retrospective analysis was conducted on the clinical data and histopathological manifestations of 279 patients diagnosed with granuloma annulare by pathology in our hospital from December 2018 to July 2024. The age, gender, lesion location, clinical subtypes, histopathological types, and misdiagnosis rate of the patients were analyzed. Results: A total of 279 patients were included, with a male-to-female ratio of 3∶4 and an average age of 48.8 years. The majority of patients (78.85%) were middle-aged or elderly (≥40 years old). In terms of clinical subtypes, there were 231 cases of localized type, 43 cases of generalized type, 3 cases of perforating type, and 2 cases of subcutaneous type. Histopathological changes were predominantly palisaded granuloma annulare in 216 cases, interstitial type in 30 cases, subcutaneous type in 27 cases, and perforating type in 6 cases. Among 279 patients, 99 (35%) were misdiagnosed. The most common misdiagnosis was eczema/atopic dermatitis (18 cases). Conclusion: The clinical misdiagnosis rate of granuloma annulare is high. It occurs frequently in middle-aged and elderly individuals. The localized type is more common clinically, and the histopathology is predominantly characterized by palisaded granuloma.

Key words: granuloma annulare, clinical features, histopathology, differential diagnosis