Perforating granuloma annualare.

Described is a 37-year-old male patient with signs and symptoms of localized perforating granuloma annulare (PGA) on the dorsa of his hands, fingers, elbows, and extensor forearms. PGA usually occurs primarily on the extremities, but the condition may be generalized. Review of the literature indicates that the cause and pathogenesis of this entity remain obscure. Sunlight may exacerbate PGA. Therapeutic success has been obtained with topical steroids with occlusion and with systemic prednisone. Our patient showed no response to liquid nitrogen but responded satisfactorily to topical steroids with occlusion.