Granuloma annulare

The Toronto Dermatology Centre is one of the premiere places in Canada to manage your skin. Our staff of outstanding dermatologists and estheticians can offer both a comprehensive assessment and diagnosis of your skin, and also discuss all your treatment options.

What is Granuloma Annulare?
Granuloma annulare is a raised, bumpy or ring-shaped lesion that may occur singly or in groups on the skin. It is especially common in children and young adults, although it may affect people of all ages, and is twice as common in women as it is in men.

What Does Granuloma Annulare Look Like?
Granuloma annulare is typically skin-colored, red, or purple. It is most often an isolated area, but may appear as several “bumps” spread all over the body. It is often seen on the tops of the hands and feet, elbows, and knees. Granuloma annulare starts as a round, firm, smooth, bump which becomes a circular ring with a clear center; similar to the shape of a doughnut. Note that there are several different appearances of this condition that your dermatologist is well familiar with.

What Causes Granuloma Annulare?
Granuloma annulare is a benign skin condition, the exact cause of which remains unknown. It is believed to be the result of a type of immune system reaction. It is not caused by an internal disease, and does not mean that you are ill. It is certainly not cancerous, nor contagious.

What Other Diseases Does Granuloma Annulare Look Like?
Granuloma annulare is most often confused with ringworm. It may also look like insect bites, or the initial rash of Lyme disease, which is called erythema migrans.

How Does Your Dermatologist Diagnose Granuloma Annulare?
Often your dermatologist is able to make the diagnosis of granuloma annulare just by examining the lesion with their eyes (“Clinical diagnosis”). A biopsy may be done to confirm the diagnosis.

How is Granuloma Annulare Treated?
Because granuloma annulare is often symptomless, no treatment is needed. The lesions may go away by themselves in a few months. Some may take years.

However, if there are many areas, or ones that are cosmetically undesirable, there are several options. Your dermatologist may prescribe a steroid cream to apply, or inject steroids directly into the spot to help it disappear faster. Applying liquid nitrogen to the lesions can also be quite helpful.

Phototherapy is sometimes used for people with widespread disease under the close supervision of a dermatologist. Other oral medications may be indicated such as isotretinoin or acitretin. More recently, biologic medications such as Humira have shown good benefit. It is important to see a dermatologist and get the correct diagnosis and the appropriate therapy.

 

Here is a selection of scientific articles by our renowned dermatologists Dr. Benjamin Barankin and Dr. Anatoli Freiman as they pertain to granuloma annulare. 

International Journal of Pediatrics and Child Health: Granuloma Annulare
What’s Your Diagnosis? Granuloma Annulare

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