History: 4282sh Man in his 70s with a 12 week history of a dermal papular rash mainly in the flexures and on non sunexposed areas .DD granuloma annulare, papular sarcoidosis, possibly lichen planus but no epidermal component. No drugs.

Description: dfermal necrobiotic granulomas

Comments: There are areas of dermal necrobiosis and associated granulomas. The granulomas comprise a mixture of mononucleated and multinucleated histiocytes as well as lymphocytes. In addition there is a perivascular infiltrate of lymphocytes. The features are those of granuloma annulare.