CORRESPONDENCE
MAURICIO GOIHMAN-YAHR, M.t)., PH.D., EDITOR The Correspondence Section serves as a forum for opinion exchange ahout subjects of general interest such as dermatologic training, relations between dermatologists and pharmaceutical houses, governmental control of dermatoiogy and medical practice in general, peculiarities of dermatology related to geographic, climatic, or racial factors, the flow of information and publications, as well as other concerns the readership might have. Coiitrihutions are welcome and should conform to the usual format for correspondence. Manuscripts will undergo standard editorial procedures. Suhmit all correspondence to Mauricio Goihman-Yahr, M.D., Ph.D., Liditor, Jet International M-154, P.O. Box 020010, Miami, FL 33102.
Familial Granuloma Annulare
attending our clinic. They were both otherwise well. Their family history was unremarkable except for diabetes mellitus in their father. Skin biopsies performed on both children showed palisading histiocytes surrounding foci of collagen degeneration. The epidermis was normal (Fig. 2).
To the Editor: Two siblings presented to the dermatology clinic with a history of sudden and simultaneous onset of multiple flesh-colored and brownish asymptomatic lesions on the upper and lower limbs (Fig. 1). The 5-year-old girl and her 10-year-old brother were children of the same parents. Their mother reported that the lesions appeared after multiple mosquito bites sustained when they spent part of Christmas holiday with their grandmother in another part of the country. The boy's lesions were annular with papular infiltrated edges and ranged from I to 2 cm in diameter. They were situated on the arms, legs, and lower buttocks. His sister hati similar annular lesions less than I cm in diameter on the arms and legs. No treatment had been administered before
Discussion Familial granuloma annulare has been described as being rare,' and recently familial perforating granuioma annulare was reported.^ In the latter report, both children developed lesions at the same time, although no predisposing factor was found. The siblings in our report had been bitten by mosquitoes, and their lesions appeared soon after. Insect bites have been proposed as a provoking factor for development of granuloma annulare,' and we believe that this was responsible for the occurrence of lesions in these two children. Marilyn Suite, M.R.C.P. Neville Jankey, M.R.C. Path. Port of Spain, Trinidad References 1. Cunliffe WJ. Necrobiotic disorders. In: Rook A, Wilkinson DS, FZbling FJG, et al., eds. Textbook of dermatology. 4th 1-d. Oxford: Blackwell, 1986:1687. 2. Abrusci V, Weiss F, Planas G. Familial perforating generalized granuloma annulare. hit J Dermatol 1988; 27: 126-127.
Figure 1. A, typical lesions of granuloma annulare on the legs of a .5-year-oid girl. B, 10-year-old boy with granuloma annulare on the arm.
Figure 2. Focus of collagen degeneration surrounded by histiocytes. 818
MAURICIO GOIHMAN-YAHR, M.t)., PH.D., EDITOR The Correspondence Section serves as a forum for opinion exchange ahout subjects of general interest such as dermatologic training, relations between dermatologists and pharmaceutical houses, governmental control of dermatoiogy and medical practice in general, peculiarities of dermatology related to geographic, climatic, or racial factors, the flow of information and publications, as well as other concerns the readership might have. Coiitrihutions are welcome and should conform to the usual format for correspondence. Manuscripts will undergo standard editorial procedures. Suhmit all correspondence to Mauricio Goihman-Yahr, M.D., Ph.D., Liditor, Jet International M-154, P.O. Box 020010, Miami, FL 33102.
Familial Granuloma Annulare
attending our clinic. They were both otherwise well. Their family history was unremarkable except for diabetes mellitus in their father. Skin biopsies performed on both children showed palisading histiocytes surrounding foci of collagen degeneration. The epidermis was normal (Fig. 2).
To the Editor: Two siblings presented to the dermatology clinic with a history of sudden and simultaneous onset of multiple flesh-colored and brownish asymptomatic lesions on the upper and lower limbs (Fig. 1). The 5-year-old girl and her 10-year-old brother were children of the same parents. Their mother reported that the lesions appeared after multiple mosquito bites sustained when they spent part of Christmas holiday with their grandmother in another part of the country. The boy's lesions were annular with papular infiltrated edges and ranged from I to 2 cm in diameter. They were situated on the arms, legs, and lower buttocks. His sister hati similar annular lesions less than I cm in diameter on the arms and legs. No treatment had been administered before
Discussion Familial granuloma annulare has been described as being rare,' and recently familial perforating granuioma annulare was reported.^ In the latter report, both children developed lesions at the same time, although no predisposing factor was found. The siblings in our report had been bitten by mosquitoes, and their lesions appeared soon after. Insect bites have been proposed as a provoking factor for development of granuloma annulare,' and we believe that this was responsible for the occurrence of lesions in these two children. Marilyn Suite, M.R.C.P. Neville Jankey, M.R.C. Path. Port of Spain, Trinidad References 1. Cunliffe WJ. Necrobiotic disorders. In: Rook A, Wilkinson DS, FZbling FJG, et al., eds. Textbook of dermatology. 4th 1-d. Oxford: Blackwell, 1986:1687. 2. Abrusci V, Weiss F, Planas G. Familial perforating generalized granuloma annulare. hit J Dermatol 1988; 27: 126-127.
Figure 1. A, typical lesions of granuloma annulare on the legs of a .5-year-oid girl. B, 10-year-old boy with granuloma annulare on the arm.
Figure 2. Focus of collagen degeneration surrounded by histiocytes. 818
