Granuloma Annulare
Last reviewed by Dr.Mary on October 4th, 2018.
What is Granuloma Annulare?
This is a skin condition that is chronic and consists of raised, skin-colored or reddish bumps or lesions that develop ring patterns, normally on the hands, elbows, knees, and feet.
These lesions can be very unsightly, but usually, cause no additional symptoms and don’t have any lasting influence on an individual’s health. But, granuloma annulare is hard to deal with if the lesions affect the appearance.
In the majority of cases, these lesions vanish on their own in 1 to 2 years. If an individual chooses treatment for cosmetic reasons, your physician can prescribe corticosteroids which improve the looks of the bumps or lesions as well as speed up the disappearance of this condition.
Granuloma Annulare Symptoms
Granuloma annulare usually is marked by:
- Reddish, skin-colored and raised bumps or lesions that can grow or can link to form patterns of a ring and are most common on the feet or hands. These patterns can resemble ringworm.
- Itching that is mild – This occurs in some individuals; however, the lesions normally cause little to no itching or pain.
The lesions can be unsightly, but granuloma annulare normally causes no other symptoms or signs. The lesions can disappear but can recur in future.
An additional widespread and severe form of this disorder is known as “generalized granuloma annulare.” With this type of the disease, the rings develop over most of the body, lesions are frequently reduced, and itching is very common.
An individual should call their primary care physician if the skin has reddish bump or lesions in ring shapes and do not go away in several weeks.
Granuloma Annulare Causes
The main cause of this skin condition is still not known. Granuloma annulare is on occasion linked with diabetes mellitus as well as other diseases, but most often when the lesions or bumps are numerous or more generalized. The majority of individuals with granuloma annulare are usually healthy otherwise.
Though this condition can affect individuals of any sex or any age group, there are some generalities. Risk aspects include:
- Being female – women are 2x as likely to have this condition
- Being a young adult or child
You are at a much greater risk of having generalized or widespread granuloma annulare if:
- Over the age of 40
- Have diabetes mellitus or diseases of the thyroid, but medical professionals do not know the reason for these associations.
Granuloma Annulare Treatment
In the majority of cases, the primary care physician can diagnose this condition by merely examining the skin that is affected. To confirm a case of granuloma annulare or to rule out other skin problems, these tests can be recommended:
Skin biopsy
With this test, a small portion of the affected skin is removed. This sample is examined under a microscope by a specialist to confirm the diagnosis.
KOH test
The doctor scrapes the skin with a glass slide to gather some dead cells of the skin. This sample is mixed with potassium hydroxide or KOH and examined under a microscope to aid in deciding if it could be an infection caused by fungus.
In the majority of cases, treatment is not necessary for granuloma annulare. Most of the lesions will disappear on their own within several months to a couple of years.
If the look of the rash bothers the individual, the doctor can suggest a treatment plan. This plan can include:
Corticosteroid ointments or creams
These medications may help to recover the appearance of the bumps or lesions as well as speed up their vanishing process. Depending on the lesion thickness and the cream strength, the doctor may advise you to protect the cream with adhesive patches or bandages. Covering any steroid cream can make it more effective.
Lesion freezing or cryotherapy
With cryotherapy, the physician applies liquid nitrogen to the areas which are affected using an applicator that is cotton-tipped or a tiny instrument intended for applying extreme cold – a device that sprays or a cryoprobe. This process lasts typically from only several seconds to one minute. The nitrogen liquid freezes these lesions, which aids to eliminate them as well as encourage new growth of cells in the skin.
Corticosteroid injections
If the skin bumps or lesions are thicker and the symptoms are more significant, the physician can inject corticosteroids – triamcinolone – directly into the skin that is affected to aid the lesions to disappear quicker.
Light therapy
With severe cases of “generalized granuloma annulare,” the physician can recommend a distinctive type of ultraviolet light treatment known as “psoralen plus ultraviolet A” – PUVA. This therapy associates the experience of ultraviolet light – phototherapy, with drugs referred to as psoralens. This helps in making the skin more amenable to properties of the ultraviolet light.
Granuloma Annulare Cure
This skin disease will eventually disappear, but it can become a chronic condition. Since granuloma annulare normally develops on the sun-exposed areas such as forearms or hands, protecting these areas from the sun by limiting exposure, cover with appropriate clothing or applying a high-quality sunscreen can also help.
Granuloma Annulare Pictures
on hands
have had granuloma annulare 13 yrs. Did not know of thyroid connection,also have Goiter. Seems to be hereditary.
I have the generalized granuloma annulare. I just started taking predinsone pills a low dose for 1 month. (yuck) i also have cortizone cream prescribed coving the reddish purple rings on my hands.
Ive had this along with polyphormoric light eurption.(GREAT) one was masking the other. so i basically had this since the end of june. it is now 9/24. I am going to keep my fingers crossed that the pred works ,it is itchy and it burns. I am going to have a thyroid test done and get tested for diabetes. I did have partial removal of my thyroid 5 yrs ago and my para thyroid was hanging by a thread so I had to get that reattached. I am not on thyroid meds. maybe i should be. I am feeling tired and ready for a nap right after I get up. feel foggy and takes a lot to get me motivated. that is not me! I’ll keep you posted : )
The predisone pills and the prescribed cortizone cream at night covered with taped gauze helped. The ringed plaques are lighter. epsom salt bath also helps with the itching
My son is 10 yrs old and we thought he had ring worm that has been coming and going on for 2 1/2 years…. Come to find out its granuloma annulare, never heard of it. As far as i know of he has no diabetes or thyroid problems but you bet your bottom dollar im asking for a test to be run. He does however suffer from a very small weak bladder at night. Now he has 4 new spots… He is on steroid cream but its not working…Thank you laine for the epsom salt idea, i’m gonna try it for him because he crys at night because it itches and burns him and the school keeps sending him home saying the dr is wrong and that its ringworm… I trust my dr and now am thinking about home schooling him because this is not going away.
They gave me ulravate ointment and it finally got rid of them. However, I am type 1 diabetic and they have now recurred on my hands with a vengeance, especially around the knuckles. They don’t itch much but i could never go to a job interview with them and they hurt if i lightly bang my hand across something. Has anyone had laser treatment?
I had it very bad for a very long time,but it eventually faded away,but after several years, It is now coming back.It doesn’t itch me, It just looks really bad. Like I have some terrible disease.
I broke out with the rings in 2001 at first they burned, then the itching started, then they didn’t hurt at all unless they were bumped. I had them on the backs of my hands up to the middle of my fingers. They spread up my forearms to my elbows. They never went anywhere else the whole time I had them. The dermatologist scraped them, stuck needles in them prescribed ointments, oral antibiotics, and prednisone. I had them on top of each other towards the end and all the doctor would say is he wasn’t sure what was going on. I became pregnant 6/2002 and stopped all forms of treatment. About 3 months into my pregnancy they started disappearing. By the time I delivered the baby they were all completely gone. I nursed my baby for about 16 months and when she was about 14 months old I had another one show up on my hand. I was devastated thinking great here we go again. It stayed about one month then disappeared. My daughter is now almost 9 and I haven’t seen anything (knock on wood). My question would be why? the treatments weren’t working but when I was pregnant I guess my body chemistry changed enough to stop hosting it? Maybe this clue will help someone find a better cure and reason it just appears and disappears without warning. My heart goes out to those who still have as I know it is uncomfortable and embarrassing. I hope the best for all and hope it doesn’t return as I get older.
I have no one in my family that has ever had Granuloma annulare…I’ve been tested for EVERYTHING and found nothing…. I have had it for about 8 years and it just seems to keep moving from my elbow and now to my knees… I haven’t found anything that works to help take it away… No one seems to know how to treat it and I’m at a loss… It seems to be getting worse and the rings are getting bigger… I wish there was a way to get rid of it! I’m tired of have to wear long sleeves to hide it…
I have GA on the back of my hands and some on my arms, mostly in the areas that are exposed to the sun. Prior to this happening I became obsessed about using hand sanitizers and antibacterial soap. I am a teacher and was trying to keep from getting sick as so many of my students take turns getting the flu, colds, etc. My hands became very very dry and then I noticed a red rash which turned out to be GA. I stopped using antibacterial products. I have always has sensitive skin and should have know better. I now only use Nutrogena and I applly vitamin E oil and an organic hand cream at nightand in the morning. The spots started to fade, but there are a couple of bad ones still hanging on. I noticed that when I am in the sun for too long they seem to get worse. I am going to try getting off of the wheat. I am also taking Norvasc which has been known to cause GA..or so I read somewhere. I am under a great deal of stress with working over ten hours a day on most days and some weekends. I love teaching, and I am grateful for the career I have, but I need to get the stress under control
I’ve had GA for more than 10 years…they’re everywhere except for my hands, thank goodness.
I look a little odd in the summer always wearing long sleeves I’ve done shots, creams and prescribed meds. My dermatologist started me on Pentoxifylline 400 mg tabs today. If it works I’ll pass the word.
I had GA when I was around ten and it went away when I started my period. someone told me about apple cider vinegar (BRAGGS) with the mother i drink about one shot glass a day and it seems to keep it at bay. I never had itching and was told it had something to do with hormones. I believe this due to the fact that mine came back at the age of forty one. If you try the vinegar option you might want to start off with two shots a day and follow with grape juice because it really does not taste so well especially to a kid. The vinegar is also a great internal cleanser my daughters use to keep weight down.
I have had GA since i was in my 40s and I am now 74. The GA keeps popping up different
places. Now it is on the back of legs. It is like little bumps. I know one other person who
has it and she had it to disappear and then come back. The dermatologist has told me
forever that it will go away. I don’t know whether to believe that or not. I wish some drug
company could come up with something that would make it go away for good.
If anyone has discovered a treatment that works please post it.