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John R. Person, MD
Auburn, Mass

Arch Dermatol. 1980;116(7):750-751.

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

To the Editor.—

I read with great interest the report by Eng¹ on erythematous generalized granuloma annulare. Both patients had pulmonary emphysema, and one had noted the onset of her dermatosis after a sunburn. The results of elastic tissue stains were not noted.

It is well known that some patients with emphysema have a genetic deficiency of ₁-antitrypsin, the major human leukocyte elastase inhibitor.²

In 1975, O'Brien³ popularized the concept of actinic granuloma, a granuloma-annulare-like dermatosis in a sun-exposed distribution. Histologically, actinic elastosis was absent inside an annular lesion but present outside it. The granulomatous infiltrate in the anulus showed histiocytes containing elastic material. The author views actinic granuloma as a specific entity that is a response to actinically damaged elastic tissue.³ O'Brien has more recently extended his concept to include temporal arteritis. He found more severe granuloma . . . [Full Text PDF of this Article]

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