Background: Granuloma annulare is a common skin disorder that usually presents with smooth papules arranged as annular plaques. Variants, such as disseminated, subcutaneous, and perforating granuloma annulare, have been described. Objective: The purpose of this study is to describe the clinical and histologic features of a distinct patch form of granuloma annulare. Methods: The clinical and histologic features of 6 patients with patch granuloma annulare were evaluated. Results: Six women 27 to 72 years of age had patches on the extremities. Two patients also had a lesion on the trunk. Only one patient had annular patches. Histologic examination showed an interstitial infiltrate of lymphocytes and histiocytes with diffuse necrobiosis. Conclusion: Patch granuloma annulare is a distinct variant with rather subtle clinical and histologic features. A high index of suspicion both clinically and histologically aids in making the diagnosis. (J Am Acad Dermatol 2000;42:417-21.)