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Arch Pathol Lab Med. 2013 Feb;137(2):255-8. doi: 10.5858/arpa.2011-0643-OA.

Wolf isotopic response manifesting as postherpetic granuloma annulare: a case series.

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  • 1Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.

Abstract

CONTEXT:

Wolf isotopic response has infrequently been reported in the literature, mainly as isolated case reports.

OBJECTIVE:

To aid in recognition of the occurrence of postherpetic granuloma annulare for accurate histologic interpretation of granulomatous dermatitides.

DESIGN:

We report 5 cases of patients with Wolf isotopic response manifesting as granuloma annulare, developing in a site of previous herpes zoster, and discuss the clinicopathologic findings.

RESULTS:

Previous infection with herpes zoster or herpes simplex virus was found in 5 of 5 cases reported. The differential diagnosis of a dermal lymphohistiocytic infiltrate with multinucleated giant cells includes postherpetic granuloma annulare.

CONCLUSIONS:

All cases of postherpetic Wolf isotopic response reported in this series revealed granuloma annulare, with a perineurovascular or perifollicular pattern of lymphohistiocytic infiltration including multinucleated giant cells, and occurred following herpes zoster or herpes simplex infection, although herpes viral infection was not always associated with a subsequent isotopic eruption. Awareness of this entity can aid in the clinicopathologic diagnosis of granuloma annulare occurring at the site of prior herpes viral infection.

PMID:
23368868
[PubMed - indexed for MEDLINE]
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