Granuloma Annulare

WHAT IS GRANULOMA ANNULARE?

Granuloma Annulare (GA) is a skin disorder that has no known cause. It appears most often over knuckles and other joints or in places that are subject to frequent, mild injury such as the back of the hands or top of the feet. It is seen most often in older children and young adults. We do see this quite often in our Jacksonville, Ponte Vedra Beach and Fleming Island patients.

WHAT ARE THE SYMPTOMS OF THE DISORDER?

The "rash" of GA is symmetrical (appears on both sides of the body more or less evenly) and formed by skin colored bumps. The bumps often expand or join to form rings. The center of each ring may be a little depressed, pale or light brown. Granuloma annulare is generally marked by:

• Raised, reddish or skin-colored bumps (lesions) that expand or join to form ring patterns, most commonly on your hands and feet. The patterns may resemble ringworm.
• Mild itching in some people, though the lesions usually cause no pain or itching.

Although the lesions may be unsightly, granuloma annulare usually causes no other signs or symptoms. The lesions may disappear and reappear at a later time.

Sometimes the diagnosis is not obvious, and other conditions may be considered. In such cases, a small biopsy will help to confirm the diagnosis.

ARE THERE ANY SYSTEMIC DISORDERS ASSOCIATED WITH GA?

Widespread (generalized GA) and this may be an entirely different condition. In these cases the bumps are often smaller and the rings harder to see. Most patients are over age 40, and there is often severe itching. Patients with generalized GA may have a tendency to diabetes mellitus and other internal problems, e.g., thyroid disorder. A biopsy and blood tests are usually needed to confirm the diagnosis.

WHAT IS THE TREATMENT?

In most cases no treatment is required. If treatment is desired, it may be helpful to apply a prescription cortisone cream to the skin. Cortisone can be injected into the lesions themselves if topicals fail.

In very widespread or bothersome cases, potent treatments are tried. These include Trental™ and Ultraviolet treatment (PUVA). Although often successful the GA tends to return eventually after they are discontinued. Other treatments occasionally tried when these fail are Dapsone™, potassium Iodide and oral corticosteroids.

For more information on granuloma annulare or to set up a consultation, click here or call 904-285-7546. Thank you and we look forward to helping you.