title: Noninfectious Granulomas: A Sign of an Underlying Immunodeficiency?
abstract: Primary immunodeficiency disorders, such as ataxia-telangiectasia (A-T), may rarely be associated with cutaneous granulomas without an identifiable infection. The authors report a case of a 3-year-old boy with A-T who presented with two persistent ulcerated erythematous nodules. Histopathology was consistent with a granulomatous process secondary to A-T, without an infectious origin. Partial improvement was noted with clobetasol propionate 0.05% cream applied twice daily under occlusion. Of note, the presence of multiple noninfectious granulomas in a child may be the initial sign of an immune deficiency and should alert the astute clinician to investigate for an underlying primary immunodeficiency. Herein, the authors discuss the associations of noninfectious granulomas and primary immunodeficiency disorders and present management options for these difficult-to-treat lesions.
authors.affiliation: Division of Dermatology, University of Calgary, Calgary, AB, Canada.
authors.forename: Ilya
authors.initials: I
authors.lastname: Shoimer
authors.affiliation: Division of Pediatric Hematology/Immunology, University of Calgary, Calgary, AB, Canada.
authors.forename: Nicola
authors.initials: N
authors.lastname: Wright
authors.affiliation: Division of Dermatology, University of Calgary, Calgary, AB, Canada richard.haber@albertahealthservices.ca.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Haber
mesh_terms: D001260:Ataxia Telangiectasia / Q000150:complications* / Q000276:immunology*; D002675:Child, Preschool; D004890:Erythema / Q000209:etiology* / Q000473:pathology; D006099:Granuloma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male
keywords: ataxia-telangiectasia; granulomas; immunodeficiency; noninfectious granulomas