Granuloma Annulare

This is a chronic skin disease that can be recognized by the small to large elevated bumps that form a ring with a normal to sunken center. This condition normally doesn’t itch and the cause is unknown, but it is considered to be a harmless condition. Adults under thirty years and children are the most affected from this condition. Those with diabetes are more prone to the condition. The condition appears more in women than men. A synonym that is sometimes used is lichen annularis.

Causes of Granuloma Annulare

While the exact cause of the condition is unknown, it is found to be associated with conditions such as diabetes, tuberculosis, insect bites, sun exposure, trauma and viral infections such as HIV, Epstein Barr virus and the herpes zoster virus. In some cases the condition may be hereditary since it has been reported in twin siblings and those who have a family history of the condition. It isn’t caused by any internal disease.

How Does Granuloma Annulare Look?

The condition is often confused with ringworm and insect bites or the start of Lyme disease. It starts as a smooth bump that expands to a circular ring with a red border and a clear center, it can start either yellow, red, purple or white. It can go unnoticed except for its appearance since it usually doesn’t burn or itch.

Symptoms of the Condition

From person to person the symptoms of this condition will vary but some of the common signs include the following:

  • The hands, feet, legs and arms will have one or more bumps.
  • The bumps will have a yellowish color.
  • During the winter months the lesions will improve but will worsen again at the start of the summer.
  • The grouped bumps may spread to annular bumps that can be anywhere between one to six centimeters in diameter.
  • In rare cases the bumps may appear on the penis and face.
  • The papules will neither scale nor hurt.
  • The papules are close enough to form a ring, but don’t actually grow together.

Diagnosis for Granuloma Annulare

A doctor will first perform a visual examination of the skin, then they will take a skin sample and review your history of diabetes.

Treatment for Granuloma Annulare

Treatment is not necessary in most cases. Limited results can be gained from topical cortisone preparations, but cortisone injections are more effective. PUVA light therapy can also be used although there is the side effect of sunburn symptoms on the areas around the affected skin. The appearance of granuloma annulare can be reduced by an application of Tranilast for three months. Although after two years the majority of granuloma annulare cases disappear on their own.

The specific treatment chosen will depend on the patient’s health, history and age as well as the severity of the condition, tolerance to specific therapies and medications and the patient’s opinion. Since a thinning of the skin can result, long-term use of steroid creams or injections should be monitored. You can have the condition surgically removed with laser treatment if the appearance is undesirable. Laser treatment is a safe method, but it may cause discomfort for three weeks. After two years granuloma annulare cures itself, but treatment can help it disappear faster.

When using steroid creams you should only rub a small amount on the area that is affected and then cover it with clear kitchen plastic wrap to keep it moisturized. After treatment you can also soak the affected area for a brief period under water. Every time you change the dressing you should reapply the steroid cream.

With this condition you don’t have to restrict any activities that you do. You can wear clothing over it since it normally doesn’t itch. Avoid excessive heat or sun exposure and try to keep the skin moisturized. If possible you should avoid any injuries to the skin.

For a period of thirty days you can try apply vinegar to the affected areas. For fifteen minutes at a time you should keep it on the papules. The appearance of granuloma annulare is reduced by the acid.

Prevention of Granuloma Annulare

Other than reducing skin exposure to sun and to follow a balanced diet with no wheat products there are no methods to prevent the outbreak of this condition. For some people the daily consumption of Romaine lettuce has worked, but the condition returns once they stop eating the lettuce.

Only a few people are affected by granuloma annulare and there is no permanent cure, since it is still unknown. In most cases it is harmless and will clear up on its own, although steroid creams or laser PUVA therapy may be required by some people to speed up the healing process.

Leave a comment

Latest Articles

Any Query?