01351nas a2200205   4500000000100000008004100001653001200042653002500054653001100079653000900090653001400099653003100113100001300144700001400157700001000171700000900181245006400190520087700254022001401131       2018                            d10aleprosy10aGranuloma multiforme10aAfrica10aAsia10adiagnosis10aSkin and connective tissue1 aBhatia S1 aShenoi SD1 aPai K1 aPs S00aGranuloma multiforme: an uncommon differential for leprosy.3 a<p>Granuloma multiforme (GM) is a chronic granulomatous skin condition which is clinically characterised by annular lesions mainly over sun-exposed areas and histologically by focal necrobiosis and histiocytic granulomas. Its significance lies in the fact that it can clinically resemble tuberculoid leprosy and hence it can be missed. Here, we report a case of GM from India in a 55-year-old female agriculturist, with multiple asymptomatic large annular rings of papules over the photo-distributed areas. Histopathology helps in confirming the diagnosis and in differentiating it from similar clinical and histologic mimics such as granuloma annulare, tuberculoid leprosy, interstitial granulomatous dermatitis or annular sarcoid. Though a high degree of suspicion is needed to diagnose GM, it should be considered as a differential for various annular conditions.</p>
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