Interstitial Granulomatous Dermatitis with Arthritis (IGDA) is an uncommon dermatologic disorder.

Synonym: Ackerman's syndrome


Key features:

(1) figurate dermatitis with cutaneous cords (rope sign, may be absent)

(2) histiocytic infiltrate in the dermis


Clinical features:

(1) erythematous, annular, linear and arciform nodules and plaques

(2) the skin lesions are sharply demarcated, indurated and non-scaly

(3) arthritis in patients with a connective tissue disease


Histologic features:

(1) The inflammatory infiltrate shows a predominance of histiocytes but eosinophils, lymphocytes and neutrophils may be present. Occasional giant cells and small granulomas may be present.

(2) The infiltrate may be palisaded around degenerated collagen fibers.

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