Annular elastolytic giant cell granuloma: sparing of a burn scar and successful treatment with chloroquine

Annular elastolytic giant cell granuloma is a rare granulomatous skin disea se characterized by phagocytosis of elastic fibres by multinucleated giant cells. Lesions are either solitary or grouped in a few annular patches with elevated borders and central atrophy. Sun-exposed areas are more commonly involved than covered skin. The pathogenesis of the disease is still contro versial. We report a 72-year-old fair-skinned woman with unusual clinical f indings. An irregularly shaped erythematous plaque covered the entire face, and hundreds of lichenoid papules were present on both sun-exposed and cov ered areas which gradually evolved into annular lesions of about 0.5-1 cm i n diameter. Sparing of an old burn scar and a nearly complete lack of elast ic fibres in the scar site were noted, illustrating the presumed importance of dermal elastic tissue in the pathogenesis. The course of the disease is chronic. Several treatments have been tried, with variable success. In our patient, improvement was achieved with chloroquine over a period of 16 wee ks.