Granuloma annulare

Overview
• DEFINITION: Granuloma annulare is a skin conditio
n that causes raised reddish or skin-colored bumps
(lesions) in a ring pattern.
• The bumps are usually on the hands and feet.
• Minor skin injuries and some drugs might trigger th
e condition. Different types affect adults and childre
n.
• The lesions usually disappear on their own within t
wo years without treatment.
 Causes
• It's not clear what causes granuloma annulare. Someti
mes i
t's triggered by:
1. Animal or insect bites
2. Infections, such as hepatitis
3. Tuberculin skin tests
4. Vaccinations
5. Sun exposure
6. Minor skin injuries
7. Drugs
• Granuloma annulare is not contagious.
 Risk factors
• Granuloma annulare is occasionally associated with
diabetes or thyroid disease, most often when lesio
ns are numerous or widespread.
• It may, rarely, be related to cancer, especially in old
er people whose granuloma annulare is severe, doe
sn't respond to treatment or returns after cancer tr
eatment.
 Symptoms
• The signs and symptoms of granuloma annulare can var
y, depending on the variety.
• Localized: This is the most common type of granuloma
annulare. The bump (lesion) borders are circular or semi
circular, with a diameter up to 2 inches (5 centimeters).
The reddish or skin-colored bumps occur most common
ly on the hands, feet, wrists and ankles of young adults.
• Generalized. Less commonly, adults experience this typ
e, which causes itchy, reddish or skin-colored bumps on
most of the body, including the trunk, arms and legs.
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• Under the skin. A type that usually affects young chi
ldren is called subcutaneous granuloma annulare. It
produces small, firm lumps under the skin, instead
of a rash. The lumps form on the hands, shins and s
calp.
 When to see a doctor
• Call your doctor if your skin develops reddish bump
s (lesions) in ring patterns that don't go away within
a few weeks.
 Diagnosis
• Your doctor may diagnose granuloma annulare by e
xamining the affected skin. He or she may take a sm
all skin sample (biopsy) to examine under a microsc
ope.
 Treatment
• Treatment usually doesn't needed for granuloma an
nulare.
• Most bumps disappear in a few months and rarely l
ast more than two years.
• But if you're bothered by how your skin looks or fee
ls, ask your doctor about treatment, which can help
them disappear faster.
Treatment options include:
• Corticosteroid creams or ointments:Prescription-st
rength products may help improve the appearance
of the bumps and help them disappear faster.
• Corticosteroid injections: If the skin lesions aren't cl
earing up with topical treatment, your doctor may s
uggest a corticosteroid injection. Repeat injections
may be needed every six to eight weeks until the co
ndition clears up.
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• Freezing: Applying liquid nitrogen to the affected ar
ea may help remove the lesions.
• Light therapy: Exposing the lesions to certain types
of light, including lasers, is sometimes helpful.
• Oral medications: In severe cases, especially when
the lesions are widespread, your doctor might pres
cribe drugs taken by mouth, such as antibiotics, an
timalarials or drugs used to prevent immune syste
m reactions.