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October 1992

Papular Umbilicated Granuloma Annulare: A Report of Four Pediatric Cases

Author Affiliations

From the Division of Pediatric Dermatology (Drs Lucky and Bove), The Children's Hospital Medical Center, Cincinnati, Ohio; Departments of Medicine (Dermatology) and Pediatrics, Duke University Medical Center, Durham, NC (Dr Prose); and the Departments of Pathology (Dr White) and Dermatology (Drs White and Jorizzo), Bowman Gray School of Medicine, Winston-Salem, NC.

Arch Dermatol. 1992;128(10):1375-1378. doi:10.1001/archderm.1992.01680200085012

• 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.

Observations.—  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.(Arch Dermatol. 1992;128:1375-1378)

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