Diagnostic dilemma of a subcutaneous nodule following a trauma in a child: immunohistochemical examination put the final diagnosis of deep granuloma annulare.

The diagnostic dilemma is discussed on a child who presented a granulomatous process of the inferior limb following a trauma. It was originally considered epithelioid sarcoma (ES) and later diagnosed as deep granuloma annulare (DGA). In combination with the clinical assessment, the plain radiographs, the ultrasound and the magnetic resonance proved inadequate in reaching diagnosis and in excluding neoplasia. Biopsy was required, and the following immunohistochemical examination put the definitive diagnosis of deep granuloma annulare. Development of DGA after trauma seems to be rare, but it is a possible event and further observations are needed to explain the triggering roles in the etiopathogenesis of this disease.