Granuloma annulare, patch type

A 64-year-old man was referred to the Bellevue Hospital Center Dermatology Clinic for evaluation of an asymptomatic eruption on his left inner arm, which had been present for 4 months and was unresponsive to topical anti-fungal therapy. One month after the initial eruption, 2 similar, asymptomatic lesions appeared on the right inner arm. The lesions were slowly expanding. The histopathology observed in a biopsy specimen from the left medial arm was consistent with interstitial granuloma annulare. The patient's clinical presentation was consistent with patch-type granuloma annulare. He was treated with a mid-potency topical glucocorticoid twice daily for 4 weeks without benefit. Because the eruption was asymptomatic, treatment was discontinued.