Papular granuloma annulare with subcutaneous granulomatous reaction induced by a bee sting.

Sir, Granuloma annulare (GA) is a benign granulomatous disease of unknown aetiology. The most common clinical manifestation is the appearance of skin-coloured small dermal nodules arranged in an annular configuration; however, several clinical variants are known, including papular (1), perforating (2), linear (3), and subcutaneous types (4, 5). We report here a case with papular GA accompanied by an extensive subcutaneous granulomatous reaction that had peculiar clinical features that were triggered by a bee sting.