Generalized granuloma annulare

Introduction
Granuloma annulare belongs to the category of dermatoses characterized by necrobiosis in histopathological examination. The disease concerns mainly people under 30 years old. There are different types of granuloma annulare: localized, generalized and subcutaneous. According to the latest scientific reports, antimalarial drugs take a significant place in the treatment of generalized granuloma annulare.

Objective
To present a case of a patient with generalized granuloma annulare and concomitant clinical signs of necrobiosis lipoidica who was treated with chloroquine with substantial improvement.

Case report
A 54-years-old patient hospitalized at the Dermatology Department because of annular and irregular erythematous-atrophic lesions on upper and lower limbs. Ulcerations were present within the lesions on lower extremities. Histopathology was indicative of granuloma annulare. Treatment with chloroquine resulted in marked improvement.

Conclusions
Generalized types of granuloma annulare are rarely observed and constitute a therapeutic challenge. Antimalarial drugs may be considered as the first-line treatment in generalized granuloma annulare.