Syphilis is one of the most common sexually transmitted diseases in the world. It is known as “the great mimicker” due to its varied cutaneous presentations, which can make it challenging to diagnose. We report a case of a 20‑year‑old female presenting with a nonhealing, pruritic, annular plaque on the left malar area of 3‑month duration. She was initially treated as a case of tinea faciei. The lesion was unresponsive to topical antifungals and steroids with continued increase in size and number. Skin biopsy revealed secondary syphilis with histopathologic features of granuloma annulare. Degenerated collagen, not a feature of secondary syphilis, was seen, prompting further studies to confirm the diagnosis of secondary syphilis. Alcian blue stain was negative, which helped rule out granuloma annulare. She was then given benzathine penicillin G 2.4 million U, which led to a significant decrease in the size of the lesion noted 1 week posttreatment. Only postinflammatory hyperpigmentation was noted after 1 month of treatment. Clinically, secondary syphilis may present as an annular lesion that can mimic tinea. This can also present with atypical histopathologic features and an in‑depth investigation is needed to further confirm the diagnosis.
Granuloma Annulare ; Syphilis

No abstract available.
Carcinoma, Hepatocellular* ; Granuloma Annulare* ; Granuloma* ; Humans

Perforating granuloma annulare (PGA), a rare variant of granuloma annulare, is characterized by transepidermal elimination of altered collagen that clinically manifests an umbilicated papule with a central crust. It can be confused with papulonecrotic tuberculid (PNT) because of their similar appearance. Unlike PGA, PNT is usually related to tuberculosis infection with a typical histologic finding of wedge-shaped dermal necrosis. Here, we report the first Korean case of PGA mimicking PNT both clinically and histologically. A 43-year-old Korean woman presented with erythematous papules localized on the extensor surface of her limbs for one year. Some of these papules had a central umbilication or a crust. Regarding comorbidity, she had latent tuberculosis diagnosed with QuantiFERON®-TB Gold test about five months ago. She was on antituberculous medication. Initially, a diagnosis of papulonecrotic tuberculid accompanied by latent tuberculosis was considered. However, despite taking the antituberculous medication for five months, her skin lesions were not improved. Biopsy specimen from her arm lesion showed wedge-shaped area of necrosis in the dermis. Additionally, there were multiple focal mucin depositions and palisading granulomatous inflammation throughout the dermis. A diagnosis of PGA was made and she was treated with topical corticosteroid. After two weeks of applying topical corticosteroid, most of her skin lesions disappeared, leaving some hyperpigmented scars.
Adult ; Arm ; Biopsy ; Cicatrix ; Collagen ; Comorbidity ; Dermis ; Diagnosis ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Inflammation ; Latent Tuberculosis ; Mucins ; Necrosis ; Skin ; Tuberculosis ; Tuberculosis, Cutaneous*

Granuloma annulare is a benign granulomatous skin disease, clinically characterized by dermal papules tending to form annular shapes. Granuloma annulare is classified into localized, generalized, subcutaneous, and perforating types. Localized granuloma annulare is likely to resolve spontaneously, while generalized granuloma annulare usually takes a chronic course. Topical steroids, phototherapy, isotretinoin, dapsone, hydroxychloroquine, and other various treatments have been proposed, but some cases have been resistant to all of those treatment modalities. We experienced 3 cases of generalized granuloma annulare demonstrating a recalcitrant course that were successfully treated with methotrexate and propose that methotrexate may be an effective option for recalcitrant generalized granuloma annulare treatment.
Dapsone ; Granuloma Annulare* ; Granuloma* ; Hydroxychloroquine ; Isotretinoin ; Methotrexate* ; Phototherapy ; Skin Diseases ; Steroids

No abstract available.
Granuloma Annulare* ; Granuloma* ; Humans

Introduction: Granuloma annulare(GA) is a benign, inflammatory skin condition characterized by asymptomatic, flesh colored or erythematous papules. The disseminated variant of granuloma annulare is uncommon, usually affecting women older than 40 years. Case Summary: We report a case of a 52-year-old female, who presented with a 4-year history of skin colored to erythematous papules and annular plaques covering the entire skin surface. Correlation of the clinical presentation, histopathology and dermoscopy findings established the diagnosis of disseminated granuloma annulare. The patient was treated with 25 sessions of narrowband ultraviolet-B (NB-UVB) phototherapy and acitretin 20mg/day for 5 months. Conclusion Both histopathology and dermoscopy were noted to be valuable tools in the diagnosis of disseminated GA, as well as in monitoring response to the combined therapy.
Granuloma Annulare ; Dermoscopy ; Acitretin

No abstract available.
Child, Preschool* ; Erythema Nodosum* ; Erythema* ; Granuloma Annulare* ; Granuloma* ; Humans ; Lower Extremity* ; Male*

Granuloma annulare is a relatively common benign dermatosis of unknown etiology. It is typically characterized by skin-colored to violaceous annular or arcuate lesions. The localized form of the disease usually resolves spontaneously, but treatment may be required in cases of intractable symptoms such as pruritus, or for cosmetic purposes. Herein, we report the case of a 65-year-old man diagnosed with a localized form of granuloma annulare that was refractory to various treatments but showed clinical improvement with a combined regimen of excimer laser and topical tacrolimus.
Aged ; Granuloma Annulare* ; Granuloma* ; Humans ; Lasers, Excimer* ; Pruritus ; Skin Diseases ; Tacrolimus*

No abstract available.
Granuloma Annulare* ; Granuloma*

No abstract available.
Granuloma Annulare ; Rheumatoid Nodule