Interstitial Granulomatous Dermatitis with Granuloma Annulare-like Features

Given the unusual localization of this granuloma annulare process to involve the groin area the patient should be evaluated for certain diseases that can be associated with the atypical granuloma annulare tissue response such as autoimmune thyroid disease, glucose intolerance and an occult paraproteinemia. Some cases of the interstitial granulomatous drug reaction can also resemble granuloma annulare. The drug history should therefore be reviewed as a drug such as a statin, ACE inhibitor or calcium channel blocker could also be potentially causative.