Granuloma Annulare

What is Granuloma Annulare?

Granuloma annulare is also called by its various types. These are generalized granuloma annulare, disseminated granuloma annulare, linear granuloma annulare, localized granuloma annulare, perforating granuloma annulare, subcutaneous granuloma annulare and just GA.

GA is a chronic skin condition that tends to gets worse over time. The cause of GA is unknown although girls get it more often than boys and primarily children and young adults get it. The National Organization for Rare Disorders notes that it tends to run in families and that people with shingles are also prone to GA.

What are the Symptoms of Granuloma Annulare?

Most types of GA feature rings or a ring of strange red or yellow bumps on the skin. Sometimes the bumps may be the same color as the patient’s skin. Any part of the body covered with skin can be affected but hands, feet and fingers are the most commonly affected areas. Disseminated granuloma annulare differs from other types by having rings in more than one place.

Subcutaneous granuloma annulare differs from other types because just one bump or nodule appears anywhere on the skin but most often on arms, legs and scalp.

Perforating granuloma annulare differs in that the bumps contain a yellow center that eventually leak pus or a clear fluid. These can leave permanent scars similar to acne scars.

Granuloma Annulare Causes

The causes of granuloma annulare are not definitively known, although there appear to be several common triggers. In general, triggers involve trauma or injury to the skin. These may be more likely to cause granuloma annulare in individuals who are already predisposed to it because of a possible genetic component. Since some forms occur more frequently in families, some researchers have hypothesized that there may be genetic factors in at least some cases.

Triggers most often associated with granuloma annulare are:

  • Insect and possibly animal bites. The condition sometimes develops after an individual is bitten by an insect. Animal bites may also be a trigger.
  • Some viral infections. These include hepatitis, HIV, Epstein-Barr, and herpes.
  • Tuberculin (TB) skin tests. Vaccinations may also be triggers.
  • Sun exposure. In some cases, sun exposure may trigger granuloma annulare.
  • Various other skin injuries. Minor trauma such as scrapes, cuts, etc. can develop into granuloma annulare.
  • Other diseases. Granuloma annulare is also linked to both diabetes mellitus and thyroid disease, particularly when there are numerous skin lesions present.

How is Granuloma Annulare Treated?

Occasionally GA will disappear as mysteriously as it appeared. About 50% of patients with localized granuloma annulare will be cured in two years without treatment. However, for most GA patients need a doctor or dermatologist’s help to make symptoms recede or disappear. Since symptoms can be similar to other skin conditions like ringworm it is best to let a medical professional do the diagnosis.

Treatment includes

Medications given include corticosteroids like dapsone and isotretinoin. Other more aggressive treatments include photochemotherapy or exposure to psoralen plus ultraviolet A radiation or PUVA. This is still considered a controversial treatment since long-terms effects of PUVA are unknown.

Granuloma Annulare Prevention

As with other diseases and disorders that have or may have a genetic component, granuloma annulare predisposition should be considered by those whose family members have a history. Individuals who are predisposed should be especially aware of the potential triggers and attempt to reduce their exposure.

Avoid insect bites whenever possible by wearing long-sleeved shirts and pants and using insect repellant and other methods to keep insects at bay.

Take measures to avoid viral infections, such as practicing proper hygiene and getting recommended vaccines and boosters on time.

Avoid overexposure to the sun. Use sunscreen and wear protective clothing, such as long-sleeved shirts and hats, to protect skin.

Get appropriate treatment for underlying conditions to minimize skin lesions. Those who have diabetes should work with their medical provider to ensure that the disease is well controlled.

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Last Reviewed:
September 21, 2016
Last Updated:
December 28, 2017
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