Annular Elastolytic Giant Cell Granuloma (AEGCG) is a rare granulomatous skin disease of undetermined cause, characterized by annular plaques with raised erythematous borders. The lesions are localized mainly in the sun exposed are of the skin. Pathogenesis of AEGCG is poorly understood. Initially described as actinic granuloma, atypical necrobiosis lipoidica and Miescher???s granuloma of the face, it is proposed that ultraviolet radiation-induced cellular immunological reaction wherein the elastin fibers immuno-pathogenicity plays a central role resulting in the formation of the elastocytic granuloma with ultimate destruction of elastin fibers. Histopathologically, it is characterized by elastin degeneration, multinucleate giant cells and elastophagocytosis. A higher incidence of diabetes mellitus has been reported with AEGCG. We report a case of a 56-years old female, diagnosed with AEGCG at the Dermatology Department of University Hospital Center of Tirana. The patient was diabetic for more than one decade. On the examination she presented well-defined skin colored to erythematous annular, well defined and arciform lesions at the face and also on the exposed areas of the neck, arms and legs. Mucosae, palms, soles, scalp, hair and nails revealed no abnormality. Skin biopsy revealed presence of epithelioid cells with many multinucleated giant cells and foreign body type with a presence of mild perivascular lymphoid infiltrate. Complete resolution was seen in two months, after starting Hydroxychloroquine 200 mg twice a day.
