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Granuloma annulare is a common condition with no known cause.
Often, people with granuloma annulare have a few red rings (usually with normal-appearing skin in the center) that can show up anywhere on the body but usually appear on the hands and feet. It often is not associated with any symptoms but can be itchy or painful.
The condition can happen to people of any age, race, or sex, but young and middle-aged women seem to get it the most.
Children get a type of granuloma annulare that shows up as nodules (or small “balls”) underneath the skin.
The condition only shows up on the skin and does not involve the rest of the body.
Diagnosis and Testing
A dermatologist can often diagnose granuloma annulare without any further testing. Sometimes, your dermatologist will take a small skin biopsy (taking a small piece of skin and looking at it under the microscope) to confirm the diagnosis. Rarely, people with granuloma annulare will have involvement of many parts of the skin or will have unusual forms of the condition. In these cases, your doctor might recommend some blood testing, including blood sugar (to look for diabetes), HIV testing, checking your cholesterol/blood fat levels, or checking your thyroid gland. Sometimes, they will recommend a blood cell count and routine cancer screenings (like a colonoscopy or mammogram).
Even without treatment, the condition will improve within 2 years in most people, but it will sometimes come back. To help granuloma annulare improve more quickly, you and your doctor can talk about some of the potential treatment options. The most common treatment is injection of a small amount of steroid into areas of skin with the condition. This helps to decrease the inflammation (white blood cells) in the area of the skin spots. Sometimes, topical steroids (creams or ointments) will be prescribed.
For people with a lot of skin involvement, your doctor might recommend treatment with light therapy (done in the doctor’s office a few times a week with a special “light box”) or with medications that you take by mouth. Many people with granuloma annulare will not need this kind of therapy.
To find this and other JAMA Dermatology Patient Pages, go to the Patient Page link on the JAMA Dermatology website at http://www.jamaderm.com.
Conflict of Interest Disclosures: None reported.
Piette EW, Rosenbach M. Granuloma Annulare. JAMA Dermatol. 2015;151(6):692. doi:10.1001/jamadermatol.2015.57
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