title: The rope sign: a case of interstitial granulomatous dermatitis with arthritis.
abstract: Interstitial granulomatous dermatitis with arthritis (IGDA), also known as Ackerman's syndrome, is a rare cutaneous disease classically characterized by the triad of cutaneous cords, a typical histologic infiltrate mainly constituted by histiocytes and arthritis/connective tissue disease. Here we report the case of IGDA with the typical clinical and histological features in a patient affected by lupus erythematosus. In this article we underline that IGDA may have a variety of different clinical and histological features. The rope sign is typical but infrequent, while histology is usually characteristic and shows a dermal inflammatory infiltrate, with a predominance of histiocytes, localized interstitially and in a palisaded array between collagen fibres, that show signs of degeneration. Clinical and histological differential diagnoses are discussed.
authors.affiliation: Unit of Dermatology, AUSL Ravenna, Ravenna, Italy - giulai87@hotmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Savoia
authors.forename: Caterina
authors.initials: C
authors.lastname: Stinchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gaddoni
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
authors.forename: Giulia
authors.initials: G
authors.lastname: Odorici
authors.forename: Vera
authors.initials: V
authors.lastname: Tengattini
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Cataleta
authors.forename: Silvia
authors.initials: S
authors.lastname: Zago
mesh_terms: D000368:Aged; D001168:Arthritis / Q000150:complications / Q000175:diagnosis*; D003872:Dermatitis / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004485:Eczema / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000473:pathology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis; D013577:Syndrome