Abstract
We report the case of a 44-year-old Indian male patient who presented with mildly tender isolated papular lesions confined to the palms of the hands and soles of the feet. The histopathology was characteristic of granuloma annulare. There was an excellent response with 4-week treatment with a potent topical steroid ointment and no recurrence was reported at the follow-up one year later. This report is interesting because of the rare presentation of a common disease.
Highlights
Granuloma annulare (GA) is a relatively common benign inflammatory disorder characterized clinically by dermal papules and annular plaques
We describe a rare case of the papular variant of granuloma annulare with isolated involvement of the palms and soles
While palms and soles are frequently involved in the less common generalized variant, they are usually spared in the localized papular variant, which typically affects the dorsa of hands and feet
Summary
Granuloma annulare (GA) is a relatively common benign inflammatory disorder characterized clinically by dermal papules and annular plaques. The patient was a farmer by occupation His past medical history was insignificant with no history or symptoms suggestive of hypertension, diabetes mellitus, chronic obstructive pulmonary disease or any nutritional deficiencies. Histological examination was done from a 3 mm sized skin biopsy specimen taken from the palm and stained with hematoxylin and eosin (H & E) It revealed hyperkeratosis, acanthosis, superficial as well as deep perivascular mixed infiltrate of lymphocytes, histiocytes and neutrophils in the dermis, over a background of incomplete collagen degeneration, with interspersed mucin (Figure 2). Treatment and follow up The patient was counselled regarding the benign nature of the disease and started on a twice daily application of a potent topical corticosteroid (clobetasol propionate 0.05%) ointment This completely resolved the papules within 4 weeks (except for mild postinflammatory desquamation) with no recurrence reported at the follow up visit one year later (Figure 3)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
