Skin nontumor

Dermal granulomatous and necrobiotic reaction patterns

Actinic granuloma



Last author update: 1 July 2011
Last staff update: 9 February 2024

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PubMed Search: Annular elastolytic giant cell granuloma

Nat Pernick, M.D.
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Cite this page: Pernick N. Actinic granuloma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorannularelastolytic.html. Accessed May 13th, 2024.
Definition / general
  • Erythematous or brown annular infiltrate in face, neck or dorsa of hands of elderly or heavily sun exposed individuals
  • May be a variant of granuloma annulare
Terminology
  • Also called O’Brien actinic granuloma or Miescher granuloma
Case reports
Clinical images

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Neck lesion

Microscopic (histologic) description
  • Dermis in region of rim has histiocytes and foreign body giant cells engulfing elastotic fibers (elastoclasis)
  • Also variable lymphocytes, plasma cells and eosinophils
  • Usually no necrobiosis, no increased dermal mucin
Microscopic (histologic) images

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Granulomatous infiltrate of multinucleated giant cells in upper reticular dermis

Elastophagocytosis
and loss of elastic
fibers in center of lesion
(orcein staining)

Differential diagnosis
  • Granuloma annulare and necrobiosis lipoidica usually have necrobiosis, increased dermal mucin
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