Case history
Case history #1
An 8-year-old girl presents with a ringed eruption on her fingers and on both hands. The lesions are asymptomatic, and the primary care physician has been treating them as ringworm. On examination there are flesh-colored papules in an annular configuration on the knuckles of both hands. The rest of the examination is unremarkable.
Case history #2
A 48-year-old woman with type 1 diabetes mellitus presents with asymptomatic annular plaques on 1 shin. There is a slightly atrophic, gold-colored area surrounding the lesions.
Other presentations
Presentation depends on subtype. Localized GA commonly presents as papules in an annular formation on the dorsum of the hands, feet, and extensor aspects. Sixty percent of all GA lesions are limited to the hands and arms.[4] Generalized GA is less common, but patients may present with numerous lesions on the torso in a symmetric distribution; facial involvement is rarely seen. Subcutaneous GA presents as solitary soft-tissue masses, most common in children <10 years of age. In adults subcutaneous lesions can be mistaken for rheumatoid nodules. The perforating form of GA presents as superficial papules on hands and fingers, with a central umbilicated crust. The patch variant is rare and presents as an erythematous plaque with a palpable border.[Figure caption and citation for the preceding image starts]: Generalized granuloma annulareFrom the collection of Susmita Mukherjee, BSc, MBBS, MRCP; used with permission [Citation ends].
[Figure caption and citation for the preceding image starts]: Generalized granuloma annulareFrom the collection of Susmita Mukherjee, BSc, MBBS, MRCP; used with permission [Citation ends].
Use of this content is subject to our disclaimer