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| Fig. 13.7 Actinic granuloma demonstrating large annular lesion on sun-exposed skin. |
Actinic granuloma, also called annular elastolytic giant cell granuloma, is a granulomatous process that tends to occur in older patients on sun-exposed skin of the face, arms, and neck. Clinically, the lesions are annular and resemble GA, although some cases demonstrate subtle atrophy in the center of the lesion (Fig. 13-7). Histologically, it is also similar to GA in that it demonstrates necrobiotic granulomas, but it differs in that it is usually more superficial, demonstrates more foreign body giant cells and prominent elastophagocytosis (macrophages engulfing and breaking down elastic fibers), and mucin is not increased. Some authorities consider it to be a variant of GA but the majority favors it being a disease
sui generis. The treatment is the same as for GA but should also include sun protection.
Stein JA, Fangman B, Strober B: Actinic granuloma,
Dermatol Online J 13:19, 2007.
