Interstitial Granulomatous Dermatitis with Arthritis (IGDA) may be associated with a number of clinical conditions. It may appear before the underlying condition is recognized.

Synonym: Ackerman's syndrome


Autoimmune disease:

(1) rheumatoid arthritis

(2) systemic lupus erythematosus (SLE)

(3) primary biliary cirrhosis

(4) autoimmune thyroiditis

(5) autoimmune hepatitis


Infectious disease:

(1) chronic hepatitis C with cryoglobulinemia

(2) coccidioidomycosis

(3) borreliosis



(1) PD-1 inhibitor therapy

(2) gabapentin

(3) trastuzumab (Herceptin)

(4) TNF-blocker

(5) anticonvulsants

(6) antihypertensive agents


Paraneoplastic syndrome:

(1) myelodysplasia

(2) solid malignancy (prostate, esophagus, other)

(3) malignant lymphoma

(4) multiple myeloma


Differential diagnosis:

(1) necrobiosis lipoidica diabeticorum

(2) granuloma annular

(3) histiocytoid Sweet syndrome

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