A Case of Granuloma Annulare Mimicking Candidal Intertrigo in the Groin

TL;DR

This paper presents a rare case of granuloma annulare in the groin that was initially mistaken for a fungal infection.

Contribution

The novelty lies in highlighting an atypical presentation of granuloma annulare and emphasizing the need for accurate diagnosis.

Findings

Granuloma annulare can present in the groin and mimic candidal intertrigo.

Biopsy confirmed interstitial granuloma annulare in a 55-year-old female.

Treatment included triamcinolone and hydroxychloroquine with pending follow-up.

Abstract

Granuloma annulare (GA) is a benign, non-infectious granulomatous skin condition of uncertain etiology, often presenting as annular erythematous plaques. While commonly localized to the hands and feet, GA has multiple clinical variants and can mimic other dermatologic conditions, leading to diagnostic challenges. We report a rare case of GA localized to the inguinal region in a 55-year-old female initially treated empirically for candidal intertrigo without improvement. Biopsy demonstrated interstitial histiocytic infiltrates dissecting between collagen bundles with increased dermal mucin, confirming a diagnosis of interstitial GA. The patient was subsequently treated with triamcinolone 0.1% ointment and hydroxychloroquine 200 mg twice daily and is currently pending follow-up. While GA often resolves spontaneously, refractory cases require individualized management, as no gold-standard therapy exists. The objective of this report is to highlight an atypical presentation of GA and emphasize the importance of maintaining a broad differential diagnosis for annular skin lesions. Further research is needed to elucidate GA’s pathogenesis and optimize treatment strategies for chronic or widespread disease.

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