Generalized granuloma annulare

Abstract

A 12-month-old child presented with asymptomatic lesions of the trunk and lower limbs started four months ago, after numerous inflammatory episodes of the upper respiratory tract. Its family history highlighted autoimmune thyroiditis in the mother, whereas the personal history did not show diseases worthy of note.
The physical examination showed on the above mentioned sites about forty papules of 2 - 4 mm, uniform in diameter, without involvement of the epidermis and without any sign of obvious inflammation. The examination of other organs did not put in evidence any abnormality.
A subcostal papule (Fig. 1, arrow) and another on the thigh (Fig. 2, arrow), which were a little larger, annular, with depressed center led us to the diagnosis of generalized granuloma annulare.
His mother before leaving remembered not having showed the ankle of the child where there were larger lesions of typical granuloma annulare (Fig. 3).