SUBCUTANEOUS PALISADING GRANULOMA OF THE SCALP IN CHILDHOOD

Subcutaneous palisading granulomas, lesions characterized by collagen necrosis and chronic inflammatory changes, may present as ill-defined, immobile, nontender masses of the scalp. They are frequently multiple and may vary in size over time. Imaging studies rarely show involveme nt of the calvarium. The histological pattern of palisading histiocyte s around necrobiotic granulomas is seen in association with a variety of systemic illnesses but more commonly occurs as an isolated entity i n childhood. They are unlikely to herald rheumatological disease unles s the erythrocyte sedimentation rate is elevated. In the presence of j uvenile rheumatoid arthritis, histological confirmation is usually not indicated. If the lesions are not associated with any other clinical symptoms excisional biopsy may be indicated to establish a diagnosis. The nodules need not be removed as they will spontaneously regress.