Generalized granuloma annulare sparing vaccination sites.

Generalized granuloma annulare (GA) is a chronic and widespread form of GA, less common than the localized type, in which the primary papular lesions may be arranged in either predominantly annular or non-annular configurations. Associations with numerous systemic disorders, including malignancies of the haematopoietic system, have been reported. There is a marked tendency to show the isomorphic or Koebner phenomenon. We report a most unusual case of generalized non-annular GA associated with chronic myelomonocytic leukaemia and myelodysplasia, in which the eruption showed striking sparing of vaccination sites.