An unusual form of generalized granuloma annulare in a patient with insulin-dependent diabetes mellitus

The generalized form of granuloma annulare may be associated with systemic disorders, including diabetes mellitus, We describe here an unusual form of generalized granuloma annulare in a patient with complicated insulin-depen dent diabetes mellitus, The cutaneous eruption had been present for decades as non-pruritic, persistent, violet-brown patches with raised edges. There were flexion deformities of the small joints of the hands and feet associa ted with thickening of the skin over dorsa of the fingers. The patient is c urrently on isotretinoin therapy, with partial resolution of lesions at 3 m onths follow-up.