A 56-year-old male developed a papule on the nuchal area, which enlarged centrifugally and formed an annular elevated plaque. Numerous papules and nodules gradually appeared on the chest, shoulders, back, upper extremities and dorsa of the hands. These eruptions had a tendency to coalesce and to form annular or serpiginous plaques. All laboratory examinations were within normal limits except for a borderline glucose intolerance. The histology of the papule manifested palisading granuloma where histiocytes, lymphocytes and multinucleated giant cells surrounded the degenerated collagen fibers. In the radial triple zone biopsy of the annular elevated plaque, elastic fibers were fragmented outside, engulfed by giant cells at the elevated area and disappeared inside. These lesions were diagnosed as generalized granuloma annulare (GGA) intermingling with histologic features of annular elastolytic giant cell granuloma (AEGCG). Our case may indicate the possibility that the series of elastic tissue changes, which characterize AEGCG, is not a specific feature but can also be seen in GGA.
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