Case Number : CT0043 Adam_Bates

Annular elastolytic giant cell granuloma

Granuloma annulare at severely sun damaged skin.
 

Agree with actinic granuloma/annular elastolytic giant cell granuloma
 

Agree with Romualdo. Actinic granuloma and its synonyms merely represent granuloma annulare in sun-damaged skin

Granuloma annulare and sun damaged skin.
 

Annular elastolytic giant-cell granuloma (actinic granuloma annulare).

Although usually on head/neck, clinical history of multifocal, bilateral involvement of both dorsal hand would be more consistent with diagnosis of AGA, and help exclude a mycobacterial process. Histologically, there is a giant cell component, and distinct absence of mucin or necrobiotic/altered collagen that would suggest a primary granuloma annulare with incidental (bystander) elastolytic component. I would suspect that an elastin stain would show reduced stainable elastin within the central areas.