title: Palisading granulomas caused by infectious diseases.
abstract: We recently encountered a palisading granuloma in which an infectious cause was not considered until special stains revealed hyphae and tissue culture revealed organisms of phaeohyphomycosis. A review of more than 2,500 cases of various granulomas revealed 11 cases of palisading-type granuloma caused by infection, including phaeohyphomycosis, nontuberculous mycobacteriosis, papulonecrotic tuberculid, tuberculoid syphiloderm, cat-scratch disease, sporotrichosis, cryptococcosis, and coccidioidomycosis. Infectious disease should be considered in the differential diagnosis of palisading granuloma. Special stains for bacteria, fungi, and acid-fast bacilli should be performed in biopsy specimens that have a palisading granuloma pattern with central necrosis, especially in immunosuppressed patients.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
authors.forename: W P
authors.initials: WP
authors.lastname: Su
authors.forename: M K
authors.initials: MK
authors.lastname: Kuechle
authors.forename: M S
authors.initials: MS
authors.lastname: Peters
authors.forename: S A
authors.initials: SA
authors.lastname: Muller
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis*; D003881:Dermatomycoses / Q000175:diagnosis*; D006099:Granuloma / Q000175:diagnosis / Q000382:microbiology*; D006229:Hand Dermatoses / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology; D008297:Male; D003904:Mitosporic Fungi; D012874:Skin Diseases, Infectious / Q000175:diagnosis*; D012878:Skin Neoplasms / Q000473:pathology