Dyslipidemia in Granuloma Annulare A Case-Control Study Dyslipidemia in Granuloma Annulare

Wu W, Robinson-Bostom L, Kokkotou E, et al. — Mon, 01 Oct 2012 00:00:00 GMT

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.

Testing Lipid Levels in Granuloma Annulare Comment on “Dyslipidemia in Granuloma Annulare”

Dahl MV. — Mon, 01 Oct 2012 00:00:00 GMT

In this issue, Wu et al report a 79.3% prevalence of dyslipidemia (DLP) among adults with granuloma annulare (GA) compared with a 51.9% prevalence of DLP in controls matched for age, sex, race/ethnicity, and presence of type 2 diabetes mellitus, hypothyroidism, and hypertension (P < .001). Although the cause of GA is unknown, the finding of DLP among so many patients comes as a surprise. Heretofore, only vague hints suggested a possible association with a lipid abnormality. Patients with generalized GA occasionally have an abnormality of glucose metabolism, microangiopathy, and microdroplet lipid deposits inside histiocytes.

JAMA Dermatology: Lipids and Lipid Disorders Topic Collection

Dyslipidemia in Granuloma Annulare A Case-Control Study Dyslipidemia in Granuloma Annulare

Testing Lipid Levels in Granuloma Annulare Comment on “Dyslipidemia in Granuloma Annulare”