Granuloma annulare - diagnostic challenges

Introduction: Granuloma annulare is a chronic, inflammatory skin disease occurring mainly in young people, predominantly in women. Skin lesions may be solitary or diffuse. They are usually located on the dorsal aspect of hands or feet and in the area of the ankles. The etiology of the disease remains unknown. A relationship between granuloma annulare and type 2 diabetes, hyperlipidemia and autoimmune diseases is postulated. Case report: We present the case of a 55-year-old woman with symetric skin lesions on extensor parts of 15 years duration. Clinically, the lesions corresponded to erythema elevatum diutinum. On the basis of histological examination, granuloma annulare was diagnosed. Conclusions: We describe a diagnostically challenging, clinically atypical granuloma anulare. In this case a histological examination was necessary to establish the diagnosis.