ABSTRACT

Actinic granuloma, O’Brien granuloma or annular elastolytic giant cell granuloma is a rare, idiopathic skin disorder of middle-aged adults characterized by granuloma annulare like plaques on sun exposed areas clinically and elastolysis, elastophagocytosis and a multinucleated cell infiltrate histopathologically. The annular plaques of actinic granuloma have atrophic or hypopigmented centers and elevated erythematous borders. The characteristic histopathological findings are nonpalisading granulomatous reaction, elastolysis, elastophagocytosis. The lesions are usually asmyptomatic but tend to persist and respond little to treatment. Several treatments have been tried with variable success. We describe a 50-year-old man presented with a 4 year history of asymptomatic, annular, erythematous plaques on dorsum of his left hand, V line of the upper chest and nape of the neck. The diagnosis of actinic granuloma was made by clinically and histopathologically and the lesions disappeared dramatically with intralesional corticosteroid injection and no recurrence has been observed in 1-year follow up.