Abstract：
Generalized perforating granuloma annulare (GPGA) is a very rare form of granuloma annulare, with only 31 reported cases to the best of our knowledge. Furthermore, GPGA is a chronic disease that mimics many diseases, with no known exact etiology, resulting in a lack of specific clinical criteria leading to a lack of guidelines for diagnosis and therapy. In GPGA, papules are the predominant lesions followed by central crusting/scaling or umbilication; pustules, plaques, annular lesions or nodules are less frequent. We report a 66-year-old woman who presented with a 7-month history of mostly asymptomatic generalized infiltrated, flesh-colored to red-brown umbilicated or crusted papules. Histopathological findings were compatible with perforating granuloma annulare. Diagnostic workup revealed latent tuberculosis. To the best of our knowledge, this is the second published case of GPGA associated with latent tuberculosis and the first one that was successfully treated by isoniazid monotherapy. From our case we can speculate and support the theory that GPGA is a phenotypic granulomatous response to multiple etiologies and/or antigenic stimulation and that testing for tuberculosis should be seriously considered in the evaluation of patients with GPGA.
摘要：
广义穿孔性环状肉芽肿（GPGA）是一种非常罕见的环状肉芽肿，据我们所知，只有31例报告病例。此外，GPGA是一种模仿许多疾病的慢性疾病，没有确切的病因，导致缺乏特定的临床标准，导致缺乏诊断和治疗指南。在GPGA中,丘疹是主要的病变，其次是中央结痂/鳞屑或脐带；脓疱，斑块,环状病变或结节的发生率较低。我们报告了一名66岁的女性，她有7个月的大部分无症状的全身浸润病史，肉色的到红棕色的脐状或结皮的丘疹。组织病理学发现与环状肉芽肿穿孔相符。诊断检查显示潜伏性结核病。据我们所知,这是第二例已发表的GPGA与潜伏性结核病相关的病例,也是第一例通过异烟肼单药治疗成功的病例.从我们的案例中，我们可以推测并支持以下理论：GPGA是对多种病因和/或抗原刺激的表型肉芽肿反应，并且在评估GPGA患者时应认真考虑结核病测试。
