Granuloma multiforme (GM) is a rare reactive, cutaneous disorder of unknown etiology that was originally described in Nigeria and has since been reported in other countries in central Africa (eg, Congo) and in Indonesia, India, and Tunisia. Prior to its description in 1964, GM was often misdiagnosed as leprosy due to its similar clinical presentation and the high prevalence in leprosy in these geographic locales. Contemporary authors have since debated whether GM is a distinct entity or a variant of granuloma annulare, necrobiosis lipoidica, or annular elastolytic giant cell granuloma (which it resembles most closely histopathologically).

GM is more commonly seen in adults older than 40 years and is predominantly seen in females. It typically begins as pruritic papules that evolve slowly over the course of a year or so into often asymptomatic annular or polycyclic plaques with raised edges that may measure up to 15 cm, which can persist for years with hypopigmentation and atrophy in the center. The sun-exposed areas of the trunk, neck, and arms are most frequently affected.