[Annular elastolytic giant cell granuloma--differential diagnosis of cutaneous granulomatosis]

Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous skin disease characterized by phagocytosis of elastic fibres by multinucleated giant cells. A 46-year-old female patient developed multiple annular lesions with elevated borders and central atrophy on the limbs. Histological examination revealed the absence of elastic material in the granulomatous infiltrate and fragments of elastic fibrils in the cytoplasm of the multinucleated giant cells. Immunohistological investigation revealed that the ratio of CD4+ to CD8+ T-lymphocytes was 3:1. Our patient was treated with clofazimine orally, 200 mg daily for the first 10 days, then 100 mg daily. After 12 weeks a definite improvement was achieved. Our case demonstrates that AEGCG, which is mostly localized on head and neck, has to be taken into account in the differential diagnosis of generalized cutaneous granulomatous disease.