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International Journal of Clinical & Medical Images

ISSN: 2376-0249

Clinical Image - International Journal of Clinical & Medical Images (2021) Volume 8, Issue 2

Granuloma Annulare Masquerading as Hansen's Disease and Showing Reverse Koebner Phenomeno

Granuloma Annulare Masquerading as Hansen's Disease and Showing Reverse Koebner Phenomeno

Author(s): Alhad Mulkalwar* and Vidya Kharkar

''An 80-year-old male presented to the department of Dermatology in October 2019 with multiple annular erythematous papules and few plaques over both upper limbs and the back. Patient had previously presented in April 2018 to a private practitioner with a large annular lesion on the right hand (Figure 1) since January 2017 and was started on multibacillary multidrug therapy for treatment of Borderline Tuberculoid Leprosy. However, while on treatment over the next one year, the lesion did not subside and he developed similar lesions over the other the contralateral shoulder and back (Figure 2). Examination revealed mildly reduced sensations over the lesions as compared to the healthy skin and bilateral thickening of the ulnar nerve, radial cutaneous nerve and cutaneous femoral nerve, clinical presentation thus mimicking Hansen’s disease. A punch biopsy was obtained from the lesion on the back which showed microscopic features of granuloma annulare and no features of leprosy (Figure 3). When the patient returned for follow-up 2 weeks later, the lesions throughout the body had resolved (Figures 4 and 5). 

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