Granuloma annulare associated with malignancy.

Granuloma annulare is a benign dermatosis. Although granuloma annulare usually occurs as an idiopathic condition, it has been described in oncology patients. I report the case of a man in whom the appearance and resolution of granuloma annulare occurred in a paraneoplastic manner. The diagnosis of his previously unsuspected pulmonary adenocarcinoma was preceded by the concurrent onset of granuloma annulare lesions and tumor-related systemic symptoms. Two other patients with malignancy-associated granuloma annulare are discussed: a woman with breast cancer and a woman with cervical cancer. In these cases, the appearance of granuloma annulare was also temporally associated with the detection of a previously undiagnosed malignancy or the discovery of recurrent metastatic disease. The resolution of the dermatosis was temporally associated with the successful treatment of the neoplasm in these individuals. Granuloma annulare should be added to the list of cutaneous paraneoplastic syndromes that may occur in patients with solid tumors.