Granuloma annulare and juvenile idiopathic arthritis: A unique case of coexistence

Granuloma annulare and juvenile idiopathic arthritis: A unique case of coexistence

Authors

  • Nasser Almulhim Dermatology Resident, King Fahad University Hospital, Khobar, Saudi Arabia
  • Shaikah Al-Aojan Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
  • Yousef Alharthi Dermatology Resident, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
  • Noorah Almaghlouth College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.

Keywords:

Granuloma annulare, Juvenile idiopathic arthritis , autoimmune diseases, Inflammatory skin disorders, Pediatric dermatology

Abstract

Granuloma annulare (GA) is a chronic inflammatory skin condition with unclear pathophysiology, potentially related to immune dysregulations. It is associated with various systemic conditions, however, its connection to juvenile idiopathic arthritis (JIA) remains unclear. Here, we present a 14-year-old girl with oligoarticular juvenile idiopathic arthritis (JIA) and a two-year history of recurrent, mildly pruritic, symmetrical ankle lesions that were intermittent and self-resolving. A punch biopsy confirmed GA, and the patient was treated with topical steroids. This case highlights a unique association between granuloma annulare and juvenile idiopathic arthritis.

References

1. Bosch-Amate X, Serra-García L, Alamon-Reig F, et al. Treatment of granuloma annulare with tofacitinib. Australas J Dermatol. 2022 Aug;63(3):400-403. doi: 10.1111/ajd.13875

2. Barbieri JS, Rosenbach M, Rodriguez O, Margolis DJ. Association of granuloma annulare with type 2 diabetes, hyperlipidemia, autoimmune disorders, and hematologic malignant neoplasms. JAMA Dermatol. 2021;157(7):817-23. doi: 10.1001/jamadermatol.2021.1805

3. Martini A, Lovell DJ, Albani S, et al. Juvenile idiopathic arthritis. Nat Rev Dis Primers. 2022 Jan 27;8(1):5. doi: 10.1038/s41572-021-00332-8.

4. Chua-Aguilera CJ, Möller B, Yawalkar N. Skin manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and spondyloarthritides. Clin Rev Allergy Immunol. 2017;53:371-93. doi: 10.1007/s12016-017-8620-5

5. Schmieder SJ, Harper CD, Schmieder GJ. Granuloma annulare. 2017.

6. Zaripova LN, Midgley A, Christmas SE, Beresford MW, Wedderburn LR, Thomson W. Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches. Pediatr Rheumatol. 2021 Aug 23;19(1):135. doi: 10.1186/s12969-021-00629-8

7. Joshi, Tejas P., and Madeleine Duvic. "Granuloma annulare: an updated review of epidemiology, pathogenesis, and treatment options." American Journal of Clinical Dermatology (2022): 1-14.

8. Lyyra, Amanda. Pro-inflammatory Alterations in Peripheral Blood T cells among Children with Juvenile Idiopathic Arthritis. MS thesis. Itä-Suomen yliopisto, 2024

9. Lovell DJ, Brunner HI, Sinha AA, et al. Prevalence of autoimmune diseases and other associated conditions in children and young adults with juvenile idiopathic arthritis. RMD Open. 2021 Mar;7(1):e001435. doi: 10.1136/rmdopen-2020-001435

10. Patrizi A, Gurioli C, Neri I. Childhood granuloma annulare: a review. G Ital Dermatol Venereol. 2014;149(6):663-74.

11. Yousaf A, Boustany OJ, Gerbo M, et al. Localized Versus Generalized Granuloma Annulare: A Retrospective Review of 407 Patients. J Cutan Med Surg. 2021 Jul-Aug;25(4):384-9. doi: 10.1177/1203475421996319

12. Nguyen TH, Gabros S, Friefeld S, Gupta A, Skopit S. Generalized granuloma annulare after COVID-19 vaccination. JAAD Case Rep. 2022;25:18-21. doi: 10.1016/j.jdcr.2022.05.003

13. Singh SK, Manchanda K, Bhayana AA, Verma A. Allopurinol induced granuloma annulare in a patient of lepromatous leprosy. J Pharmacol Pharmacother. 2013;4(2):152-4. doi: 10.4103/0976-500x.110915

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Published

07-08-2026

Issue

Section

CASE REPORTS

How to Cite

1.
Almulhim N, Al-Aojan S, Alharthi Y, Almaghlouth N. Granuloma annulare and juvenile idiopathic arthritis: A unique case of coexistence. Acta Biomed. 2026;97(4):18435. doi:10.23750/abm.2026.18435