title: Papular umbilicated granuloma annulare. A report of four pediatric cases.
abstract: BACKGROUND
  Granuloma annulare is a common skin condition usually presenting as annular plaques composed of intradermal papules. Variants such as disseminated, subcutaneous, and perforating have been described. In this article, the clinical and histologic features of a distinct papular umbilicated form of granuloma annulare are described.
  
  
  METHODS
  Four boys aged 5 to 9 years presented with papular, umbilicated, flesh-colored papules limited to the dorsa of the hands and fingers. Histologically there were unusually distributed but typical features of granuloma annulare, including well-demarcated areas of necrobiosis of collagen, localized beneath areas of epidermal thinning and parakeratosis. There was no perforation.
  
  
  CONCLUSIONS
  Papular umbilicated granuloma annulare appears to be a distinct variant that may be difficult to diagnose because of its unique clinical and histologic features.
authors.affiliation: Division of Pediatric Dermatology, Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: A W
authors.initials: AW
authors.lastname: Lucky
authors.forename: N S
authors.initials: NS
authors.lastname: Prose
authors.forename: K
authors.initials: K
authors.lastname: Bove
authors.forename: W L
authors.initials: WL
authors.lastname: White
authors.forename: J L
authors.initials: JL
authors.lastname: Jorizzo
mesh_terms: D002648:Child; D002675:Child, Preschool; D016460:Granuloma Annulare / Q000473:pathology*; D006229:Hand Dermatoses / Q000473:pathology*; D006801:Humans; D008297:Male