Generalized granuloma annulare. A report of a case and review of the literature

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Abstract
A patient with generalized granuloma annulare is described. The eruption was restricted to exposed sites. Forty-seven cases from the literature are reviewed. The clinical appearance may be confused with lichen planus, sarcoidosis, tuber-culpsis cutis, and lichen myxedematosus. The histology is variable and collagenous; cellular or vascular changes may occur separately or in combination. Treatment with gold injections, antihistamines, X-ray therapy, and bismuth have not been consistently effective. Claims for improvement with diethylstibestrol, systemic corticosteroids, and penicillin have been made but these are difficult to assess because of the variable course of the disease. Antimalarials may be of value.

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