Granuloma annulare is an immunological hypersensitivity reaction to some unknown agent, manifesting as a benign skin rash. It can last for months or years and generally heals over time and without the need for treatment.
What Is Granuloma Annulare?
Granuloma annulare is a benign skin eruption of inflammatory-granulomatous origin, of unknown cause and generally self-limiting.
Why Is It Produced?
The ultimate cause of granuloma annulare is not known, but it is known to be an immunological hypersensitivity reaction to some unknown agent. Some factors that can trigger its appearance are insect bites, skin tests, vaccines, infections, localized trauma, sun exposure, or some medications. Sometimes it is related to diabetes, thyroid diseases, and rarely to cancer.
It is twice as common in women as in men and appears at any age, but it predominates in young adults and children.
It is a chronic condition with a tendency to resolve on its own, but it frequently occurs with remissions and relapses, which can have psychological repercussions for the patient. Granuloma annulare is not contagious.
The lesions are usually small red/violaceous papules or lumps, hard on palpation, which are grouped into a ring. The surface of the skin does not change, that is, it does not flake, nor do vesicles or pustules appear. The center of the ring is usually sunken and with normal skin. The lesions appear on the back of the hands, and feet, but also on the forearms, elbows, or knees.
Types Of Granuloma Annulare
There is great variability in its form of presentation. The main types of granuloma annulare are as follows:
- Localized: It is the most common form of granuloma annulare and usually affects young adults. The lesion is unique, does not usually itch, and measures between 1 and 5 cm. It is located in the hands, feet, wrists, or ankles. Heals in months or up to 2 years without leaving a scar.
- Generalized or extended: it is rare and affects adults. The lesions are numerous and are distributed over the trunk, neck, and proximal regions of the extremities. May cause itching.
- Subcutaneous: It is a rare form of granuloma annulare, which affects children under 5 years of age. It is characterized by the fact that the lesions are subcutaneous (under the skin) in the form of small nodules. It can appear on the hands, scalp, or pretibial area (pimples) and is usually self-limited.
Diagnosis
The diagnosis is made by the dermatologist with a visual inspection of the skin. Sometimes a biopsy is needed to confirm the diagnosis.
Treatment
Granuloma annulare can last for months or years and usually heals over time and without the need for treatment. The treatment helps the lesions to disappear sooner, but it is frequent that they reappear.
The specialist will be the one who will indicate the best type of treatment, depending on the extent of the disease, the presence or absence of pruritus, and the degree of psychological involvement of the patient.
Topical corticosteroids can be given in the form of a cream or corticosteroids in local injections. Other options are topical tacrolimus, cryotherapy (freezing the lesion with liquid nitrogen), or phototherapy. In generalized and chronic forms, different drugs can be administered orally.
What you should know…
- It is known to be an immunological hypersensitivity reaction to some unknown agent. Some factors that can trigger its appearance are insect bites, skin tests, vaccines, infections, localized trauma, sun exposure, or some medications.
- It manifests as a benign skin rash of inflammatory-granulomatous origin, which can last for months or years and generally heals over time and without the need for treatment.
- The specialist will be the one who will indicate the best type of treatment, depending on the extent of the disease, the presence or absence of pruritus, and the degree of psychological involvement of the patient.
