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| Fig. 13.6 A, Typical lesion of granuloma annulare demonstrating raised annular lesions without scale. B, Subcutaneous granuloma annulare of proximal second toe. |
Granuloma annulare (GA) typically presents with violaceous or flesh-colored dermal papules arranged in an annular or semiannular configuration (Fig. 13-6A). The lesions may be solitary or multiple. Most commonly, it affects the dorsum of the hands or feet, but it can also occur on the forearms, arms, legs, or thighs. It tends to affect children or young adults with a 2:1 female preponderance. Several less common variants of granuloma annulare include the macular and erythematous forms, subcutaneous nodules (Fig. 13-6B), actinically induced lesions, perforating type, and disseminated form. Biopsies of GA demonstrate a characteristic palisaded granuloma associated with collagen destruction (necrobiotic granuloma) and increased dermal mucin.
Arroyo MP: Generalized granuloma annulare,
Dermatol Online J 9:13, 2003.
