Granuloma Annulare

Diagnosis: Granuloma Annulare

Annular lesion composed of many closely-set papules on the dorsum of the foot.

Clinical Presentation

Annular lesion composed of many closely-set papules on the dorsum of the foot.

Clinical History

Submitted by Alaa Saad. Originally posted October 28, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Tinea corporis • Annular lichen planus • Sarcoidosis • Necrobiosis lipoidica • Morphea • Erythema annulare centrifugum • Mycosis fungoides

Key Learnings

• Classic appearance: flesh-colored to erythematous annular plaques with a raised border and depressed center • Localized form is most common (75%) — often on dorsal hands/feet • Generalized form: consider screening for diabetes mellitus (controversial association) • Palisading granulomatous inflammation with central mucin and collagen degeneration on histology • Self-limited in ~50% of localized cases within 2 years • Dermoscopy: structureless orange-yellow areas ("setting sun" pattern)

Tags: granuloma, annulare, alaa saad