皮膚科 王修含醫生

各種Granuloma annulare (GA)的鑑別診斷心法:

台大皮膚科  王修含 醫師

先配合Annular lesion without epidermal change:
4S A LEG的口訣 --> 初步排除非GA的診斷
SCLE
Sarcoidosis
Syphilis
Sjogren's syndrome

Actinic granuloma

Leprosy
EAC
Granuloma annulare

再進入各種GA的鑑別診斷，進一步確認病灶是GA

1. Localized GA
Annular lichen planus
Erythema annulare centrifugum
Erythema elevatum diutinum
Erythema migrans of Lyme disease
Leprosy
Necrobiosis lipoidica diabeticorum

2. Generalized GA
Cutaneous metastases
Cutaneous paraneoplastic syndrome
Lichen myxedematosus
Lichen planus
Sarcoidosis

3. Subcutaneous GA
Epithelioid sarcoma
Rheumatoid nodule

4. Perforating GA
Elastosis perforans serpiginosa
Molluscum contagiosum
Perforating collagenosis

5. Actinic granuloma
Erythema annulare centrifugum
Necrobiosis lipoidica diabeticorum
Sarcoidosis

Summarized by 王修含 2005.7.19