Five cases are reported as examples of the subcutaneous form of granuloma annulare. Classical cutaneous lesions appeared at approximately the same time in cases 1 and 2; in other instances (cases 3 and 4) the subcutaneous lesions preceded the classical ones; a brother of this last patient (case 4) presented only subcutaneous nodular lesions (case 5). Although biopsy was not performed, his eruption was regarded as an example of subcutaneous granuloma annulare because of the morphologic features, course, spontaneous regression, and the sibling association.
Because of the paucity of reported examples of familial incidence of granuloma annulare a description of a cousin of the two siblings (cases 4 and 5) who presented classic cutaneous (but not subcutaneous) granuloma annulare has been included (case 6). These related children had their disease concurrently.