Generalized perforating granuloma annulare: a case report and review of the literature.

A nineteen year old girl with mongolism and generalized perforating granuloma annulare of the lower legs is presented herein. Skin biopsy specimens showed dermal necrobiosis and epidermal perforation. The literature is reviewed and summarized. The lesions have been characterized as small, often umbilicated papules occurring in large numbers on the extremities.