Generalized granuloma annulare associated with chronic hepatitis B virus infection

We describe a 63-year-old Chinese woman with generalized granuloma annulare (GGA) associated with chronic hepatitis B virus (HBV) infection for 10 years. She developed non-annular papule lesions after a previous infection of hepatitis B virus. Since then, her clinical course was aggressive with involvement of the trunk, extremities and neck. Histologically, granulomatous inflammations were found in the upper to mid dermis. The HBV DNA in these lesions was demonstrated by polymerase chain reaction (PCR). GGA was totally regressed after treatment of interferon-alpha for 3 months. To the best of our knowledge, GGA associated with chronic HBV infection has never been reported in literature. The prognostic significance of the association of granulomatous inflammation and virus infection is reviewed.