Answer to last month's Clinical Quiz

Question:
This 53 years old gentleman complained of an itchy eruption on the dorsa of his hands.

Answer:
C. Granuloma annulare

Granuloma annulare (GA) is a degenerative disease of the skin, histologically characterised by focal degeneration of collagen with lymphohistocytic granulomata. Several clinical forms have been described and this localised form is the commonest. The typical lesion consists of small and smooth violaceous papules arranged in an annular fashion. Since the inflammation is deep in the dermis, epidermal changes like scaling and vesiculation are absent.

The association with diabetes mellitus (DM) is well known. Patients with GA should be checked for DM. The lesion may improve spontaneously or after minor trauma e.g. skin biopsy. Local corticosteroids, either topical or intralesional can be used for treatment of localised disease.