A case of localized multiple subcutaneous granuloma annulare on the fingers of a patient with mixed connective tissue disease manifesting raynaud's phenomenon

39-year-old woman presented with a two-year history of Raynaud's phenomenon and a diagnosis of mixed connective tissue disease (MCTD). She has had multiple subcutaneous nodules on her fingers for one year. At her first visit to our clinic, a total of 12 subcutaneous nodules of up to 3 mm in diameter were observed on the fingers bilaterally. Histological examination of biopsy specimens of the nodules revealed that the nodules were composed of palisading granuloma from the deep dermis to the subcutis, with central necrobiosis and mucin deposition. The final diagnosis was subcutaneous granuloma annulare(GA)in the presence of MCTD. To the best of our knowledge, this is the first case of multiple GA lesions comorbid with MCTD. Because the lesions were distributed only on the fingers, circulatory dysfunction and subsequent tissue damage caused by Raynaud's phenomenon might have been involved in the development of granuloma annulare in this patient.