Granuloma annulare – diagnostic challenges

Abstract

Introduction: Granuloma annulare is a chronic, inflammatory skin disease occurring mainly in young people, much more often in women. Skin lesions may be solitary or diffuse. They are usually located on the backs of the hands or feet and around the ankles. The etiology of the disease remains unknown. A relationship between granuloma annulare and the occurrence of type 2 diabetes, hyperlipidemia or autoimmune diseases is postulated. Case report: We present the case of a 55-year-old woman with bilateral skin lesions on extensor parts of her elbows, who for over 15 years remained without an accurate diagnosis. Clinically, the lesions corresponded to persistent and haughty erythema. Finally, on the basis of histological examination, granuloma annulare was diagnosed. Conclusions: In special cases, granuloma annulare may be a dermatosis that is difficult to diagnose solely on the basis of the clinical presentation. A histological examination are then necessary.