Actinic granuloma of the conjunctiva

Actinic granuloma is a condition showing actinic elastosis accompanied by a chronic inflammatory cell infiltrate and multinucleated giant cells absorbing elastotic fibers. ¹ It differs from granuloma annulare by the absence of necrobiotic collagen and palisading histiocytes. ^1,2 Lesions typically occur in the skin and begin as papules that progress to plaques and then to incomplete or complete annular lesions. In the conjunctiva, actinic elastosis is the hallmark of Pingueculae ³ and to the best of our knowledge has been noted in association with a granulomatous reaction in only one previous report. ⁴ We recently studied a conjunctival lesion with the histologic features of actinic granuloma.