"Dick and Syme syndrome" (perforating granuloma annulare, episcleritis, eosinophilia, positive reaction to intradermal tuberculin): a new entity?

We report a case of 'Dick and Syme syndrome' in a 44-year-old woman. The syndrome was characterized by multiple perforating granuloma annulare on the hands, left idiopathic nodular episcleritis, eosinophilia and positive reaction to intradermal tuberculin, without symptoms or signs of tuberculosis. This case, the second reported in the literature after the original one described by Dick and Syme in 1982, would confirm that the above-mentioned tetrad is not accidental but constitutes a distinct entity.