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What is Granuloma Annulare?

Granuloma annulare is a common, usually self – limiting skin condition of either localized or generalized course.
Around 70% of the patients with granuloma annulare are young adults, up to around 30 years old. Children up to 15 years old make up around 40% of the patients. Even though the young people constitute the vast majority of the affected individuals, it is not impossible for an elderly person to acquire granuloma annulare as well. The extensive form of this condition is more commonly seen when accompanied by diabetes mellitus, hyperlipidaemia, or HIV infection.


The exact cause of granuloma annulare is unknown. Possible precipitating factors include an autoimmune disease, viral infection, sun exposure, or a response to trauma.

What are some common signs & symptoms?

The disease begins as a skin colored, asymptomatic papule with a lightened center. With time, there appear multiple, skin-colored, pink, or purple papules forming a singular or numerous annular lesions on the skin. Granuloma annulare can form in an oval or irregular shape, usually progressively reaching a diameter of around 2 inches. The lesions most often affect the lateral or dorsal surfaces of the hands and the ankles, including the locations above small joints. In 50% of the patients, they last for up to 2 years. In about 40% of adults, recurrent granuloma annulare is seen in the same location. Rarely, predisposed patients may acquire a generalized form of the disease. In this case, multiple ring – forming papules occur in the numerous body areas. Granuloma annulare can also affect the skin folds of the trunk, like armpits or the groin.

What are some treatment options?


Often, no treatment is required for granuloma annulare as it frequently subsides on its own, especially if singular. If granuloma annulare becomes bothersome, or has a more wide-spread distribution, some patients may opt for treatment. Typically, either topical or intralesional steroids are used including triamcinolone, clobetasol, fluticasone, and/or mometasone. The strength of topical steroids can be increased by additional occlusion, while the intralesional steroids are administered via injections into the brim of an annular lesion. Pennsylvania Dermatology Specialists will provide you with a personalized pharmacological treatment plan if needed.


Another effective option in the treatment of granuloma annulare, especially when the lesions are numerous or generalized, is phototherapy. In this case, usually the narrowband UVB radiation is used. It possesses the wavelength of 311 – 312 nm, which has been proven extraordinarily successful in decreasing the appearance of various skin conditions. It is non – invasive, and can be safely repeated. Pennsylvania Dermatology Specialists will individually adjust the phototherapy parameters for the best possible results.

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