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Granuloma Annulare — SCE Dermatology MCQ

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HardInflammatory DermatosesGranuloma AnnulareSCE Dermatology

A patient develops flexural erythematous-to-violaceous plaques after starting a new antihypertensive. Biopsy shows an interstitial histiocytic infiltrate surrounding fragmented collagen, with interface change and scattered eosinophils. Which diagnosis is most likely?

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Correct answer: D — Interstitial granulomatous drug reaction

The combination of an interstitial granulomatous infiltrate, interface dermatitis, eosinophils and a temporal drug relationship supports an interstitial granulomatous drug reaction. Interstitial granuloma annulare may look similar but generally lacks the drug-associated interface and eosinophilic clues.

Reference: https://academic.oup.com/bjd/pages/bad-guidelines