Atypical granuloma annulare. Transition from erythema to multiple type.

We studied a 53-year-old housewife who had atypical granuloma annulare (GA) which began as erythematous patches on the legs. After 2 months, multiple flat papules, histologically characteristic of GA, developed over the erythematous background. 1 1/2 years later, a typical annular lesion appeared on the right index finger. Differential diagnosis of the erythematous form of GA based only on the clinical manifestations is difficult.