Granuloma Annulare – Causes – Symptoms and Treatment

Granuloma annulare (GA) is a common condition. GA is a self-limited cosmetic disease without systemic medical complications. GA has been epidemiologically associated with diabetes mellitus, necrobiosis lipoidica diabeticorum, and rheumatoid nodules. It most often appears on the knuckles and other joints or in places that are subject to frequent minor injuries, such as the back of the hands or the tops of the feet. It is seen most often in older children and young adults. Granuloma annulare (GA) is a self-limited benign dermatosis characterized by a raised annular configuration. Sometimes it appears at the site of a previous penetrating injury. PG is often seen in infancy and childhood, but it can also be seen in adults, particularly pregnant women. PG is a benign vascular tumor, which occurs mainly in childhood. Lesions can bleed and ulcerate.

PG may affect white populations more than other racial groups, but this is not well proven and the observation may reflect sampling bias. Sometimes GA is quite widespread (generalized GA) and this can be a completely different condition. GA has been associated with diabetes mellitus and thyroid disease based on increased numbers of GA patients with these diseases in small case series. Most patients are over 40 years old, and there is often severe itching. Patients with generalized GA characteristically present with a few to thousands of 1–2 mm papules or nodules that range in color from skin tones to erythematous and involve multiple body regions, and patients with subcutaneous GA have firm, painless skin. colored or pink nodule without overlying epidermal alteration.

Causes of granuloma annulare

1. Granuloma annulare.

2. Pyogenic granuloma.

3. Diabetes mellitus.

4 herpes zoster lesions

Symptoms of granuloma annulare

Reddish or skin-colored bumps (lesions).

2. Mild itching.

3. Nodule under the skin of the arms or legs.

Treatment of granuloma annulare

Nuisance patches may improve with the use of steroid creams or ointments, or occasionally steroid injections into the rings. Sometimes it is helpful to apply a strong steroid preparation to the skin or steroids can be injected into the bumps. Small dishes can be frozen (cryotherapy). Topical imiquimod and topical calcineurin inhibitors (tacrolimus and pimecrolimus) have been reported to help in individual cases. Surgical tape saturated with an injected corticosteroid or corticosteroids can help clear up the rash. People with large affected areas often benefit from a treatment that combines phototherapy (exposure to ultraviolet light) with the use of psoralens (drugs that make the skin more sensitive to the effects of ultraviolet light). This treatment is called PUVA (psoralens plus ultraviolet A).

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