“It began on my left breast two years ago,” recited a seventy-six-year-old woman. It looked like ringworm, but it wasn't. Today she had extensive large, red, circular plaques on her left breast, right armpit, both thighs, and the groin. The borders were rimmed by thickened red skin.

She had never had skin disease before, but she was sensitive to sulfonamide and tetracycline medications. She was taking five different pills for heart disease. Nothing had helped her skin.

Our examination revealed no fungi on skin scrapings, and a skin biopsy confirmed our clinical diagnosis of granuloma annulare. This ring of cord-like chronic inflammation is a strange skin reaction with many different causes. We have seen it from yeast infection, but anti-yeast medication did not clear hers. We have seen it disappear completely simply as a result of taking a skin biopsy, but no such luck for her. We also have seen it from a focus of bacterial infection, but even our best antibiotic for cystitis did not prevent new lesions from appearing on her skin. Her blood studies were normal and gave us no clue as to where to turn.

We tried another antibiotic, and yet another, to no avail. There were new lesions on her left forearm. They were mammoth. We tried suppressing her immunity with no help. We now found that she had developed diabetes and hoped her internist's treatment for this would help, but it did not.

She entered the hospital for surgery on her spine.