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August 1987

Pruritic, Pink, Papular Eruption

Author Affiliations

Harvard Medical School, Boston

Arch Dermatol. 1987;123(8):1073-1074. doi:10.1001/archderm.1987.01660320115025

REPORT OF A CASE  A 46-year-old man presented with a generalized eruption of 3½ years' duration. The rash began, without associated illness, as scattered pink papules on the flanks and progressed without remission. The eruption was mildly pruritic. The patient had no known medical problems. There was a family history of adult-onset diabetes mellitus.On examination, there was a generalized eruption of thousands of 1-mm papules with colors that ranged from skin-tone to red (Fig 1). Most of the papules coalesced to form circinate patterns without epidermal change. The soles were involved, but the palms, scalp, and mucocutaneous membranes were spared.Findings of a complete blood cell count, 12-factor automated chemical analysis, chest roentgenographic examination, and glucose tolerance test were all normal. Histopathologic examination revealed multiple foci of degenerating collagen surrounded by inflammatory infiltrates in a radial arrangement (Figs 2 and 3).What is your diagnosis?

DIAGNOSIS:  Generalized granuloma annulare (GA).

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