Skin nontumor

Dermal granulomatous and necrobiotic reaction patterns

Annular elastolytic giant cell granuloma

Last author update: 1 July 2011
Last staff update: 17 July 2020

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PubMed Search: Annular elastolytic giant cell granuloma

Nat Pernick, M.D.
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Cite this page: Pernick N. Annular elastolytic giant cell granuloma. website. Accessed September 29th, 2023.
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
  • 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

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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