Successful Treatment of Actinic Granuloma With Pulsed-Dye Laser and Fractionated Carbon Dioxide Laser

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Actinic granuloma, also known as O'Brien granuloma, is an uncommon, benign, granulomatous condition characterized by annular plaques on sun-exposed areas of the skin, and there is a paucity of published efficacious treatment options. We present a case of a 66-year-old man with actinic granuloma who achieved aesthetic improvement after pulsed-dye laser (PDL) and fractionated carbon dioxide (CO2) laser. Researchers have hypothesized that the pathogenesis of actinic granuloma is due to an autoimmune response against actinically damaged elastic fibers.1 Actinic granuloma shares several clinical features with granuloma annulare, and some researchers consider it to be a subtype of granuloma annulare occurring on the sun-exposed skin.1 Actinic granuloma is aesthetically disfiguring and can significantly affect patient quality of life. Treatment of actinic granuloma is challenging, as these lesions tend to persist, showing little to no response to topical or intralesional corticosteroids.2 Patients are typically advised to avoid sun exposure and apply sunscreen to prevent the development of new lesions.
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