Acute-onset, painful acral granuloma annulare: a report of 4 cases and a discussion of the clinical and histologic spectrum of the disease.
BACKGROUND
Granuloma annulare is a benign cutaneous inflammatory disease of unknown etiology most commonly presenting on the hands and feet and consisting of asymptomatic to mildly pruritic, flesh-colored to erythematous annular plaques. To our knowledge, an acute-onset, painful acral eruption has not been previously recognized.


METHODS
We report 4 patients who presented with acute-onset, painful acral granuloma annulare.


CONCLUSIONS
It is possible for granuloma annulare to present as a painful eruption with an acute onset and an acral distribution. Biopsy results are a crucial factor when establishing the diagnosis of this atypical clinical presentation of granuloma annulare.
Brey
Nicole Vessels
NV
Division of Dermatology, Department of Medicine, School of Medicine, University of Louisville, KY 40202, USA.
Malone
Janine
J
Callen
Jeffrey P
JP
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005385:Fingers; D016460:Granuloma Annulare / Q000150:complications / Q000473:pathology*; D006801:Humans; D008663:Metacarpus; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*