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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 trig gered by a bee sting. CASE REPORT A 63-year-old man noticed a reddish, oedematous, painful swelling of the left middle finger immediately after a bee sting. The oedema was transient, but a few days after the bee sting, diffuse swelling without ten derness re-appeared and gradually, within one month, spread to both hands and all fingers. The patient was treated unsuccessfully with systemic corticosteroids (prednisolone 15 mg/day). Two months after the bee sting, he was admitted to our hospital.

Papular Granuloma Annulare with Subcutaneous Granulomatous Reaction Induced by a Bee Sting