Granuloma Annulare : Cause, Symptoms and Treatment

What is Granuloma Annulare?

Granuloma Annulare is a skin condition which is chronic in nature. In this disorder, ring-shaped lesions appear which are raised and bumpy. These lesions can be reddish or skin colored. There can be single or multiple lesions. It is more commonly observed on hands and feet. These lesions are harmless and cause no danger.

People of any age can get affected by it but children and young adults are more affected. Women are more prone to Granuloma Annulare than men; in the ratio of 2:1. There are no other particular signs other than lesions. Presence of these lesions makes skin unsightly. These lesions usually disappear themselves within two years without any treatment. But treatments are available to speed up the healing process which patients can follow for fast recovery.

What is the Appearance of Granuloma Annulare:

Lesions of Granuloma Annulare may appear reddish, pearly-white, purple or skin-colored. These bumps are usually limited to an area but there may be several bumps on whole body. Initially, these small lesions start, with a firm and smooth bump and then gradually expand and form a ring pattern; the whole lesion resembles like a doughnut.

There is usually no itching and peeling; it makes it unnoticed often. But sometimes, there may be mild itching. It may be present on any area of skin but is often located on tops of feet, hands, knees and elbows.

A more sever form of granuloma annulare is called generalized granuloma annulare. In this condition, there are many rings present on the body and also lesions are smaller and often have mild itching.

What Causes Granuloma Annulare

What causes Granuloma Annulare, is still unknown, but there may be something related to the immune system. Apart from having Granuloma Annulare, person is otherwise healthy. Most of the people do not have any problem other than lesion on the skin.  

How to Diagnose Granuloma Annulare

Lesions of Granuloma annulare often confused with lesions of ringworm. It may also be confused with rashes appear in early stages of insect bite. It is important for the doctor to carefully examine the rashes and identify the disorder by right diagnosis.

Doctor may advice skin biopsy to confirm the Granuloma annulare. And a blood test may also be conducted.

What is the Treatment Available for granuloma annulare :

In most cases, there is no treatment needed for granuloma annulare. Lesions appeared due to granuloma annulare, get clear off without any treatment within few months to two years.

These lesions often appear unsightly and if you have cosmetic concern, you can consult a doctor for treatment which will speed up the healing process of granuloma annulare. Treatment prescribed by doctor may include:

Application of Corticosteroid creams:

To improve the appearance of the rash or to accelerate the process of disappearance of the lesions, doctor may advice corticosteroid topical creams like clobetasol propionate. The type and strength of cream is advised according to the thickness of the lesion. Doctor may advice to cover the lesion after application of cream. Effectiveness of cream increases if it covered with bandage.

Other treatment option is giving Corticosteroid injections. If skin lesions are thicker and larger, doctor may administer corticosteroid injections directly into affected part of the skin; it is very fast treatment to remove lesion.

Cryotherapy or freezing the lesions is yet another treatment. In this process, liquid nitrogen is applied on the affected skin area, using a cotton-tipped applicator or a small instrument for its application in extreme cold. It is a very small procedure which usually takes only few seconds to a minute to complete.

This procedure is very effective; liquid nitrogen freezes the lesion and helps to crust and peel it off. Further, it stimulates the growth of new skin cells.

Light Thereapy:

In more serious cases of generalized granuloma annulare where person has lesions on all over the body, doctor may prescribe a kind of ultraviolet light therapy. This light therapy is called psoralen plus ultraviolet A (PUVA). In this treatment, skin is exposed to ultraviolet light rays and at the same time drugs are given to make the skin more receptive to the effects of ultraviolet light.

Another type of light treatment is relatively new and under research. This is called narrowband ultraviolet B (UVB) phototherapy.