Hypergranulosis

Hypergranulosis is a term pathologists use to describe an increased number of cells in the granular layer of the skin. The granular layer is normally a thin layer found close to the skin’s surface, within a part of the skin called the epidermis. Hypergranulosis is a benign (non-cancerous) descriptive finding rather than a diagnosis on its own. Pathologists note this finding when examining skin samples under a microscope.

What does the granular layer normally do?

The granular layer is an important part of healthy skin and typically consists of one or two layers of cells. Under a microscope, these cells contain dark purple granules, which give this layer its name. These granules help strengthen the skin and maintain moisture, contributing to the protective barrier function of the skin’s surface.

What causes hypergranulosis?

Hypergranulosis can occur in response to various skin conditions and external factors, including:

• Viral warts: Hypergranulosis is often seen in warts caused by the human papillomavirus (HPV).

• Rashes and inflammatory conditions: Chronic skin conditions such as eczema or lichen planus frequently show hypergranulosis.

• Skin trauma: Repeated rubbing, scratching, or other mechanical irritation can lead to hypergranulosis.

• Chronic inflammation: Persistent inflammation from conditions such as psoriasis or dermatitis can cause hypergranulosis.

• Certain types of nevi (moles): Some benign moles can display hypergranulosis.

Hypergranulosis often appears alongside other skin changes such as hyperkeratosis (thickening of the outer keratin layer) and acanthosis (thickening of the epidermis).

How is hypergranulosis diagnosed?

Hypergranulosis is diagnosed by a pathologist examining a skin biopsy under a microscope. The pathologist looks for a thickened granular layer containing an increased number of cells with prominent granules. While hypergranulosis alone is not diagnostic, identifying this feature helps pathologists determine the underlying skin condition or reaction.

Is hypergranulosis harmful?

Hypergranulosis itself is harmless and not cancerous. However, it usually reflects an underlying skin condition or reaction that may require attention or treatment.

How is hypergranulosis treated?

Treatment depends on the underlying cause of hypergranulosis:

• Viral warts: Treatments include topical therapies, freezing (cryotherapy), or removal by a dermatologist.

• Inflammatory skin conditions: Topical corticosteroids, moisturizing creams, or other medications may reduce inflammation and improve skin health.

• Chronic trauma or irritation: Avoiding scratching, wearing protective clothing, or using emollients may help prevent and reduce skin irritation.

Questions to ask your doctor

• What could be causing the hypergranulosis in my skin?

• Does the hypergranulosis indicate an underlying skin condition that needs treatment?

• Will the hypergranulosis go away on its own, or should it be treated?

• Are there specific skin-care practices I should follow to help manage or prevent hypergranulosis?

• Should I be concerned about any serious skin conditions associated with this finding?