Clinical Features of Generalized Granuloma Annulare in Korea

Abstract

Background: Generalized granuloma annulare (GGA) is a benign granulomatous disease of an unknown etiology. Although numerous studies about GGA have been reported, publications that describe the general clinical features of the disease are very sparse. Objective: This study aimed to identify the clinical characteristics of Korean GGA cases. Methods: We reviewed and analyzed the clinical data derived from four patients diagnosed with GGA at our hospital and the clinical data from 58 patients diagnosed with GGA at other Korean hospitals between 1995 and 2011. Results: The cutaneous lesions could be divided into the annular (n=30, 48%) and nonannular (n=32, 52%) types, and the lesions were more common in males than in females, with 33 males and 29 females affected. The GGA incidence showed a bimodal distribution with respect to age at disease onset. Twenty-six cases (42%) presented within the first decade of life and 29 cases (47%) presented when they were in the fifth decade of life or older. Twelve patients (19%) had systemic diseases. Of note, diabetes mellitus (DM) occurred only in adult GGA patients who were aged over 40 years. Conclusion: In contrast to previously reported studies, this study shows that the age at GGA onset has a bimodal distribution, and that GGA occurs more often in males. The prevalence of DM among GGA-affected individuals was higher than that found in the general Korean population. Therefore, a DM workup should be undertaken for GGA-affected patients who are over 40 years of age.