# Subcutaneous Granuloma Annulare in a Middle-Aged Patient: A Case Report

## TL;DR

A middle-aged woman with subcutaneous granuloma annulare was diagnosed and treated with conservative care and steroid injections.

## Contribution

This case report presents a rare manifestation of subcutaneous granuloma annulare in an adult and highlights the diagnostic and treatment approach.

## Key findings

- The patient's diagnosis was confirmed via punch biopsy, showing typical features of granuloma annulare.
- Intralesional triamcinolone injections were effective in managing recurrent lesions after initial resolution.
- Accurate diagnosis through clinicopathologic correlation is essential for proper management.

## Abstract

Subcutaneous granuloma annulare (SGA) is a rare, benign variant of granuloma annulare, typically seen in children, which presents as asymptomatic subcutaneous nodules with normal overlying skin. The etiology remains unclear despite associations with systemic disease such as diabetes mellitus. Clinicopathologic correlation is crucial to accurate diagnosis. In this report, we present a case of a 53-year-old female patient with tender, bilateral subcutaneous nodules on her elbows. Punch biopsy confirmed the diagnosis of granuloma annulare. The primary management for her condition at the time was focused on observation and conservative care. However, secondary management with intralesional injection of triamcinolone was utilized when her lesions recurred after a window of resolution. Our case highlights an interesting manifestation of granuloma annulare and demonstrates the importance of both clinical and histological evaluation in distinguishing between similar presenting differential diagnoses. Successful treatment is heavily dependent on accurate diagnosis and patients should be monitored for complete resolution.