Uncommon granulomatous skin disease is called an annular elastolytic giant cell granuloma (AEGCG). It belongs to a class of ailments affecting elastic fibers and the skin. It is also known as actinic granuloma when it affects the skin that has been exposed to the sun. The pathophysiology and etiology were under discussion.

Though the etiology of cases in sun-covered places was uncertain, sun-induced actinic damage to elastic fibers was regarded as the key triggering cause. Diabetes mellitus is the systemic condition that is most frequently related. According to several case reports, the illness was linked to hematological disorders, infections, sarcoidosis, and protoporphyria. In one example, there was additional evidence of multisystemic participation. Erythematous, non-scaly annular plaques and patches with elevated borders and skin-colored or hypopigmented cores, occasionally atrophic, are the clinical hallmarks of the illness.

Usually, it has no symptoms or only slight itching. Histopathological features include an inflammatory infiltration with non-palisading granulomas, multinucleate big cells, elastin breakdown, and elastophagocytosis, but not necrobiosis or mucin. Researchers described a 66-year-old lady with a history of type 2 diabetes mellitus, hypertension, and fatty liver disease who developed an annular elastolytic giant cell granuloma 5 years ago (steatosis). She had mostly sun-exposed patches of polymorphic erythematous skin lesions when she first appeared with no symptoms.

Reference: escholarship.org/uc/item/3s82x7dh