The lesions are symmetrically placed in these areas.
Pathology: Two 3 mm punch biopsies taken.
Diagnosis: Granuloma annulare
The clinical picture is unusual, but in retrospect, it fits. Perhaps, this is an example of generalized G.a. The patient is otherwise healthy but we have no recent lab tests. It may be prudent to obtain A1c, chemistry and lipid profile.
What are your thoughts?
1. Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature.
Watanabe S et.a.l Dermatol Pract Concept. 2014 Jan 31;4(1):97-100. Free Full Text Online