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Dyslipidemia in Granuloma Annulare:  A Case-Control Study

Wesley Wu, MMSc; Leslie Robinson-Bostom, MD; Efi Kokkotou, MD, PhD; Hye-Young Jung, BA; George Kroumpouzos, MD, PhD
Arch Dermatol. 2012;148(10):1131-1136. doi:10.1001/archdermatol.2012.1381.
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Objectives  To estimate the prevalence of dyslipidemia (DLP) among individuals with idiopathic granuloma annulare and to examine associations with disease characteristics and comorbidities, such as metabolic syndrome.

Design  Case-control study using review of medical records from January 2002 through December 2010.

Setting  A university hospital and a health care system.

Participants  Adults consisting of 140 patients and 420 individuals serving as controls matched for age, sex, race/ethnicity, hypertension, type 2 diabetes mellitus, and hypothyroidism.

Main Outcome Measures  Prevalence of DLP and its associated components (hypercholesterolemia, hypertriglyceridemia, elevated low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol) in idiopathic granuloma annulare, as well as odds ratio of DLP after adjusting for confounding variables.

Results  The prevalence of DLP was 79.3% among granuloma annulare cases and 51.9% among controls (P < .001). Granuloma annulare was associated with DLP (odds ratio, 4.04; 95% CI, 2.53-6.46) after adjusting for confounding variables. Statistically significant differences between patient and control groups were found for levels of total cholesterol, triglycerides, and low-density lipoprotein cholesterol (P < .001 for all variables). A statistically significant association between the extent of disease and DLP (P = .02) was shown. Annular lesion morphology was associated with hypercholesterolemia (P = .02) and DLP (P = .01).

Conclusions  This study indicates an association between granuloma annulare and DLP. Dyslipidemia is more common in generalized than in localized/disseminated disease, and the annular lesion morphology is associated with hypercholesterolemia and DLP. Physicians should be aware of these important associations and consider them in the management of granuloma annulare.

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