A case of generalized perforating granuloma annulare is presented in a 6-year-old girl. The clinical appearance of umbilicated papules initially suggested a perforating dermatosis. Two skin biopsy specimens demonstrated a necrobiotic palisading granulomadle in the midcorium and upper corium. Serial sections were required to demonstrate the perforation of necrobiotic material through the overlying epidermis.
Izumi AK. Generalized Perforating Granuloma Annulare. Arch Dermatol. 1973;108(5):708-709. doi:10.1001/archderm.1973.01620260056023