Tightly-packed collection of macrophages imprisoning foreign organisms or other materials which cannot be eliminated by the immune system.Encyclopedia Entry for Granuloma :Granuloma inguinale - Donovanosis- Klebsiella granulomatis (G- rod)Encyclopedia Entry for Granuloma :Granuloma annulare. GA most often affects children and young adults. It is slightly more common in females. The condition is usually seen in otherwise healthy people. Sometimes, it may be associated with diabetes or thyroid disease. The exact cause of GA is unknown.GA usually causes no other symptoms, but the rash may be slightly itchy. People usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands, or feet. Occasionally, they may find a number of rings. In rare cases, GA appears as a firm nodule under the skin of the arms or legs. In some cases, the rash spreads all over the body.Your health care provider may think you have a fungal infection when looking at your skin as the ring shape may look like ringworm. A skin scraping and KOH test can be used to tell the difference between GA and a fungal infection. You may also need a skin punch biopsy to confirm the diagnosis of GA.GA can resolve on its own. You may not need treatment for GA, except for cosmetic reasons. Very strong steroid creams or ointments are sometimes used to clear up the rash more quickly. Injections of steroids directly into the rings may also be effective. Some providers may choose to freeze the bumps with liquid nitrogen. People with severe or widespread cases may need medicines that suppress the immune system. Laser and ultraviolet light therapy (phototherapy) may also help.In most cases, GA disappears without treatment within 2 years. But, the rings can remain for many years. The appearance of new rings years later is not uncommon.Call your provider if you notice a ring-like bumps anywhere on your skin that do not go away within a few weeks.Pseudorheumatoid nodule - subcutaneous granuloma annulare; GA.Granuloma annulare - close-up Granuloma annulare - close-up Granuloma annulare on the eyelid Granuloma annulare on the eyelid Granuloma annulare on the elbow Granuloma annulare on the elbow Granuloma annulare on the legs Granuloma annulare on the legs.Habif TP. Cutaneous manifestations of internal disease.Encyclopedia Entry for Granuloma :Granulomatosis with polyangiitis. GPA mainly affects blood vessels in the lungs, kidneys, nose, sinuses, and ears. Other areas may also be affected in some cases. The disease can be severe and prompt treatment is important. The exact cause is unknown, but it is an autoimmune disorder. GPA is most common in middle-aged adults of northern European descent. It is rare in children, but has been seen in infants as young as 3 months old.Frequent sinusitis and bloody nose are the most common symptoms. Other early symptoms include a fever that has no clear cause, night sweats, fatigue , and a general ill feeling ( malaise ). Other common symptoms may include: Chronic ear infections Pain, and sores around the opening of the nose Cough with or without blood in the sputum Chest pain and shortness of breath as the disease progresses Loss of appetite and weight loss Skin changes such as bruises and ulcers of the skin Kidney problems Bloody urine Eye problems ranging from mild conjunctivitis to severe swelling of the eye. Less common symptoms include: Joint pain Weakness Abdominal pain.You may have a blood test that looks for proteins called antineutrophil cytoplasmic antibodies (ANCA). These are often found in people with active GPA. However, this test is sometimes negative, even in people with the condition. A chest x-ray will be done to look for signs of lung disease. Urinalysis is done to look for signs of kidney disease such as protein and blood in the urine. Sometimes urine is collected over 24 hours to check how the kidneys are working. Blood tests may be done to exclude other illnesses. These may include: Antinuclear antibodies Anti-glomerular basement membrane (anti-GBM) antibodies C3 and C4, cryoglobulins, hepatitis serologies, HIV Liver function tests Tuberculosis screen and blood cultures A biopsy is sometimes needed to confirm the diagnosis and determine how severe the disease is. A kidney biopsy is most commonly done. You may have one of the following: Nasal mucosal biopsy Open lung biopsy Skin biopsy Upper airway biopsy Other tests that may be done include: Sinus CT scan Chest CT scan.You will probably be treated glucocorticoids (such as prednisone). These are given along with other medicines that slow down the immune response. Medicines used with prednisone to treat GPA include: Rituximab (Rituxan) Cyclophosphamide (Cytoxan) Methotrexate Azathioprine (Imuran) Mycophenolate These medicines are effective in severe disease, but they may cause serious side effects. Talk to your health care provider about your treatment plan. Other medicines used for the condition include: Medicines to prevent bone loss caused by prednisone Folic acid or folinic acid, if you are taking methotrexate Antibiotics to prevent lung infections.Support groups with others who suffer from similar diseases may help people with the condition and their families learn about the diseases and adjust to the changes associated with the treatment.Without treatment, people with severe forms of this disease can die within a few months. With treatment, the outlook for most patients is good. Most people who receive corticosteroids and other medicines that slow the immune response get much better. The disease may return about half the time. It often comes back within 2 years of stopping treatment, so ongoing follow-up and possibly treatment are needed.Complications most often occur when the disease is not treated. People with GPA develop tissue damage in the lungs, airways, and the kidneys. Kidney involvement may result in blood in the urine and kidney failure. Kidney disease can quickly get worse. Kidney function may not improve even when the condition is controlled by medicines. If untreated, kidney failure and possibly death occur in most cases. Other complications may include: Eye swelling Lung failure Coughing up blood Nasal septum perforation (hole inside the nose) Side effects from medicines used to treat the disease.Call your provider if: You develop chest pain and shortness of breath. You cough up blood. You have blood in your urine. You have other symptoms of this disorder.There is no known prevention.Formerly: Wegener's granulomatosis.Adenocarcinoma - chest x-ray Adenocarcinoma - chest x-ray Granulomatosis with polyangiitis on the leg Granulomatosis with polyangiitis on the leg Respiratory system Respiratory system.Falk RJ, Gross WL, Guillevin L, et al. Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis. Ann Rheum Dis. 2011;70(4):704. PMID: 21372195 www.ncbi.nlm.nih.gov/pubmed/21372195. Specks U, Merkel PA, Seo P, et al. Efficacy of remission-induction regimens for ANCA-associated vasculitis. N Engl J Med. 2013;369(5):417-427. PMID: 23902481 www.ncbi.nlm.nih.gov/pubmed/23902481. Stone JH. The systemic vasculitides.Encyclopedia Entry for Granuloma :Granuloma inguinale (Donovanosis). Source of disease: Klebsiella granulomatis