They are typically asymptomatic, single or multiple, annular or polycyclic lesions measuring up to 6 cm in diameter, with slow centrifugal expansion, an erythematous elevated edge, and a hypopigmented, atrophic center.

Though these can be easily distinguished based on histopathologic features and laboratory findings, the differential diagnosis includes tinea corporis, sarcoidosis, subacute lupus erythematosus, granuloma annulare, and other infectious granulomatous diseases.

[4] The lesions, which primarily affect sun-exposed areas such as the face, neck, chest, and upper arms, begin as red or skin-colored papules and progress insidiously to annular plaques with uplifted edges and atrophic central skin.

[3] Solar-damaged elastic fibers are thought to be the initial cause of this disease, acting as an antigenic trigger for a CD4+ T-helper cell-mediated granulomatous immune response.

Sarcoidosis lesions, on the other hand, are typically symmetrically distributed on the face, neck, upper trunk, and extremities, particularly within preexisting scars or near sites of prior trauma.