Rosh Pediatrics Practice Exam

What is the typical presentation of a child diagnosed with granuloma annulare?

1. Itchy, scaly rash

2. Circular smooth lesions without inflammation

3. Papules forming a target-like appearance

4. Large, ulcerated lesions

The correct answer is: Circular smooth lesions without inflammation

Granuloma annulare typically presents as circular, smooth lesions that are generally skin-colored or slightly erythematous. These lesions are characteristic in that they often have a raised, annular (ring-like) appearance with no inflammation, making them different from other dermatological conditions that involve itchiness, scaling, or ulceration. In granuloma annulare, the lesions are painless and not associated with significant symptoms, which is why the description of smooth and non-inflammatory is key to recognizing this condition correctly. The lesions may vary in size but are usually not large and do not easily crust or ulcerate. Contrastingly, other skin conditions mentioned in the answer choices involve inflammation, itchiness, or more complex formations, distinguishing them from the straightforward and non-symptomatic nature of granuloma annulare. Thus, the presentation of circular smooth lesions without inflammation is a hallmark symptom of granuloma annulare.