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Arch Dermatol. 2004;140:877-882.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Papular umbilicated granuloma annulare (GA).

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Microscopic examination of the biopsy specimen showed focal crust overlying a thinned epidermis, with areas of parakeratosis. The underlying papillary and reticular dermis contained focal areas of "necrobiosis" surrounded by lymphocytes, palisading histiocytes, epithelioid cells, and occasional multinucleated giant cells (Figure 3 and Figure 4). The patient was given trials of niacinamide and tazarotene cream, with no improvement of the GA. Oral hydroxychloroquine sulfate therapy (200 mg twice daily) was initiated and continued for 20 months. The GA began clearing in several months and was completely resolved after 18 months of hydroxychloroquine treatment.

Figure appears in full text version. Figure 3.

Figure appears in full text version. Figure 4.

DISCUSSION

The vast majority of cases of GA occur in persons younger than 30 years.¹ Granuloma annulare usually appears as skin-colored papules that evolve to form annular plaques, which are most often localized to acral sites, such as the dorsal aspect of the hands and feet. The clinical characteristics include localized and . . . [Full Text of this Article]

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Arch Dermatol. 2004;140(7):877-882.
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