Actinic Granuloma
A 50 yr old patient with an 18 month history of asymptomatic lesion on forehead and the dorsum of her hands was presented. The lesions were well demarcated, erythematous, coalescing annular plaques with raised border and slight atrophic centers. Over the tim the lesion extended in number and centrifugally. A biopsy showed skin lymphohistiocytic infiltrate with multinucleated giant cell with surrounding solar elastosis without apparent palisading necrobiosis or mucin deposition. Fragmentation of the elastic fiber and occasional phagocytosis by the giant cells in the granulomatous area were noted. DIAGNOSIS: Finding the supported diagnosis of Actinic Granuloma. It is an asymptomatic reaction that effects sun exposed skin , most commonly on the face, neck and scalp. It is characterized by annular or polycyclic lesion that slowly expands centrifugally and has erythematous elevated edge and hypopigmented atrophic center. TREATMENT: Treatment with topical helometasone cream on the dorsum of her jand with pimecrolemous cream on her forehead was started; At two month there was a partial response. DIRECTION: The patient was advised to reduce her exposure to sun and to use sun-screen.
