Papular Granuloma Annulare

Three children, ages 3, 6, and 7, with a papular form of granuloma annulare occurring on their exposed skin, are reported. Contact with Culicoides furans suggests this biting gnat as the cause of their eruptions. All had an eosinophilia of from 6% to 10%, and the possibilities of either an allergic or a mechanical mechanism causing the eruption are considered. Local trauma by freezing and systemic steroids, as well as protection from the gnat, caused improvement in the eruption.