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Giornale Italiano di Dermatologia e Venereologia 2016 February;151(1):102-5

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

The rope sign: a case of interstitial granulomatous dermatitis with arthritis

Francesco SAVOIA 1, Caterina STINCHI 1, Giuseppe GADDONI 1, Annalisa PATRIZI 2, Giulia ODORICI 2, Vera TENGATTINI 2, Pierluigi CATALETA 3, Silvia ZAGO 4

1 Unit of Dermatology, AUSL Ravenna, Ravenna, Italy; 2 Department of Specialist, Diagnostic and Experimental Medicine Division of Dermatology University of Bologna, Bologna, Italy; 3 Department of Internal Medicine AUSL Ravenna, Ravenna, Italy; 4 Unit of Pathologic Anatomy AUSL Ravenna, Ravenna, Italy


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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.

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