Granuloma annulare with follicular perforation.

An instance of perforating granuloma annulare was observed in a 42-year-old female patient in which the necrobiotic material in the dermis was eliminated by a hair follicle. This had previously been described by the author in only 1 other case of perforating granuloma annulare. Transepithelial elimination may occur by the transepidermal and/or transfollicular route. Both pathways are possible in perforating granuloma annulare. Some factors are discussed which may be responsible for the predominance of one route over the other in various disorders of transepithelial elimination.