Subcutaneous granuloma annulare in an adult

A 38-year-old female presented with a history of recurrent multiple deep dermal nodules located on the dorsa of the feet, over the ankle joints and lower pretibial area. Laboratory investigation excluded rheumatoid arthritis. Histopathological examination showed changes in the deep dermis: histiocytes in palisades around foci consisting of degenerated bundles of collagen, mucin, fibrin and "nuclear dust". The diagnosis of subcutaneous granuloma annulare was made on the basis of the clinical and histological features. Treatment with dapsone was successful, and in the course of two months the nodules disappeared.