Skin nontumor
Dermal granulomatous and necrobiotic reaction patterns
Actinic granuloma
Author: Nat Pernick, M.D.
Last author update: 1 July 2011
Last staff update: 9 February 2024
Copyright: 2002-2025, PathologyOutlines.com, Inc.
PubMed Search: Annular elastolytic giant cell granuloma
Table of Contents
Definition / general | Terminology | Case reports | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Pernick N. Actinic granuloma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorannularelastolytic.html. Accessed April 2nd, 2025.
Definition / general
- Erythematous or brown annular infiltrate in face, neck or dorsa of hands of elderly or heavily sun exposed individuals
- May be a variant of granuloma annulare
Terminology
- Also called O’Brien actinic granuloma or Miescher granuloma
Case reports
- 45 year old woman with growing lesion in neck (Dermatol Online J 2011;17:7)
Clinical images
Images hosted on other servers:
Neck lesion
Microscopic (histologic) description
- Dermis in region of rim has histiocytes and foreign body giant cells engulfing elastotic fibers (elastoclasis)
- Also variable lymphocytes, plasma cells and eosinophils
- Usually no necrobiosis, no increased dermal mucin
Microscopic (histologic) images
Images hosted on other servers:
Granulomatous infiltrate of multinucleated giant cells in upper reticular dermis
Elastophagocytosis
and loss of elastic
fibers in center of lesion
(orcein staining)
Differential diagnosis
- Granuloma annulare and necrobiosis lipoidica usually have necrobiosis, increased dermal mucin
