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Interstitial granulomatous drug reaction
Other Resources UpToDate PubMed

Interstitial granulomatous drug reaction

Contributors: Susan Burgin MD, Michael D. Tharp MD, Neil Shear MD
Other Resources UpToDate PubMed


The interstitial granulomatous drug reaction (IGDR) is a skin eruption with distinctive clinical and histopathological findings. Lesions are usually localized to skin folds, are asymptomatic, and may not begin until several weeks, months, or even years after drug initiation. Most lesions resolve over weeks following drug cessation. The exact mechanism is unknown.

Calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, lipid-lowering agents, antihistamines (H2 receptor antagonists), furosemide, carbamazepine, anti-tumor necrosis factor (TNF) agents, bupropion and tricyclic antidepressants, and soy have all been implicated.

Related topic: Interstitial granulomatous dermatitis


L27.1 – Localized skin eruption due to drugs and medicaments taken internally

81119003 – Dermatitis due to drug AND/OR medicine taken internally

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Interstitial granulomatous dermatitis associated with internal disease.
  • Systemic lupus erythematosus
  • Granuloma annulare
  • Cutaneous T-cell lymphoma, granulomatous type
  • Erythema annulare centrifugum
  • Rheumatoid arthritis
  • Lichenoid drug eruption
  • Annulare erythema of Sjögren syndrome

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:07/11/2018
Last Updated:07/11/2018
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Interstitial granulomatous drug reaction
A medical illustration showing key findings of Interstitial granulomatous drug reaction : Linear configuration, Trunk, Annular configuration, Erythematous or violaceous plaques
Clinical image of Interstitial granulomatous drug reaction - imageId=595837. Click to open in gallery.  caption: 'A close-up of a red and violaceous, scaly and crusted nodule and a nearby dull red papule.'
A close-up of a red and violaceous, scaly and crusted nodule and a nearby dull red papule.
Copyright © 2024 VisualDx®. All rights reserved.