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A Report of 4 Cases and a Discussion of the Clinical and Histologic Spectrum of the Disease

Nicole Vessels Brey, MD; Janine Malone, MD; Jeffrey P. Callen, MD

Arch Dermatol. 2006;142:49-54.

Background  Granuloma annulare is a benign cutaneous inflammatory disease of unknown etiology most commonly presenting on the hands and feet and consisting of asymptomatic to mildly pruritic, flesh-colored to erythematous annular plaques. To our knowledge, an acute-onset, painful acral eruption has not been previously recognized.

Observations  We report 4 patients who presented with acute-onset, painful acral granuloma annulare.

Conclusions  It is possible for granuloma annulare to present as a painful eruption with an acute onset and an acral distribution. Biopsy results are a crucial factor when establishing the diagnosis of this atypical clinical presentation of granuloma annulare.

Author Affiliations: Division of Dermatology, Department of Medicine, School of Medicine, University of Louisville, Louisville, Ky.

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