GRANULOMA ANNULARE

General Information

DEFINITION--A chronic benign skin disorder characterized by lesions that appear in the shape of a ring. This is not malignant or contagious.

BODY PARTS INVOLVED--Skin on the bottoms of feet and backs of fingers, hands, arms, elbows, legs and knees.

SEX OR AGE MOST AFFECTED--All ages, but most common in children (4 to 12 years).

SIGNS & SYMPTOMS--

Papules (small, raised bumps on the skin) with the following characteristics:

• Papules have a domed or slightly flat shape, 3mm to 6mm in diameter.
• Papules are non-scaling.
• Papules are pink or violet. Those on the lower extremities are darker than ones on other parts of the body.
• Papules don't itch or hurt.
• Multiple papules cluster in a ring. Ring diameters range from 1cm to 10cm. Papules around the ring border are close but don't grow completely together. This gives the border a beaded appearance. The ring's center is often darker than the edge. Ringed lesions change in size and shape over a period of several weeks to 6 months.

CAUSES--Unknown.

RISK INCREASES WITH

• Diabetes mellitus.
• Positive family history of granuloma annulare.

HOW TO PREVENT--Avoid injury to the skin. Protect skin from sunburn with sunscreen or clothing.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Biopsy (See Glossary) to confirm diagnosis (sometimes).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS--Recurrences of the disorder.

PROBABLE OUTCOME--Spontaneous recovery within 2 years, but therapy may hasten recovery.

How To Treat

GENERAL MEASURES--

• Protect involved areas from injury.
• No treatment is usually necessary.

MEDICATION--Your doctor may prescribe topical steroids with occlusion to hasten healing. To use steroids:

• Gently rub a small amount of the steroid drug into the affected area.
• Reapply a small amount.
• Cover the affected area with clear kitchen plastic wrap. If skin becomes dry and itchy, provide additional moisture by covering the affected area with a damp, clean cloth before applying plastic. You may also soak the affected area briefly in water after applying medicine.
• Reapply medicine every time you change the plastic dressing.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of granuloma annulare.
• Lesions ulcerate.
• New lesions occur during treatment.
• Signs of infection, such as redness, swelling, pain or tenderness, develop around the lesions.
• You become sensitive to the occlusive plastic dressing.
• New, unexplained symptoms develop. Steroid drugs used in treatment may produce side effects.