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Granuloma Annulare


Disease: Granuloma Annulare Granuloma Annulare
Category: Dermatological diseases
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Disease Definition:

Granuloma annulare is a chronic skin condition that consists of raised, skin-colored or reddish bumps, also called lesions, which form ring patterns. Mostly, these occur on hands and feet.


Granuloma annulare doesn't have any long-term impact on a person's health, and it doesn't cause any other signs or symptoms except for lesions, which in some cases could be unpleasant. However, if someone's lesions are visible enough to affect his/her appearance, they could be hard to cope with.


Mostly, within two years, the lesions disappear on their own. Corticosteroids could improve the appearance of the lesions and speed their disappearance. So if someone prefers treatment of granuloma annulare for cosmetic reasons, they may be prescribed corticosteroids.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Some of the signs and symptoms that granuloma annulare is characterized by include:


  • Raised, reddish or skin-colored bumps, also called lesions which expand or join together to form ring patters, usually on the hands and feet. These patterns are similar to ringworm
  • Although lesions usually don't cause any pain or itching, however, in some people, they may cause mild itching.


Granuloma annulare usually doesn't cause any signs or symptoms except for lesions, which could be unsightly in some cases. Generalized granuloma annulare is a more severe and widespread form of this condition. In this type, the lesions are smaller, itching is more common and the rings appear over much of the person's body. In case someone's skin develops reddish bumps or lesions in ring patterns that don't go away with a few weeks, the person should see a doctor.


The exact cause of granuloma annulare is still not known. Although most people with granuloma annulare are otherwise healthy, but in some cases, this condition could be associated with diabetes and thyroid disease.





Granuloma annulare usually doesn't require any treatment, and within a few months to two years, most lesions disappear on their own. However, a person may be recommended a treatment plan in case the appearance of the rash bothers them, such as:


Corticosteroid injections:

In order to help the lesions disappear faster, a person may be injected with corticosteroids directly into the affected skin. This will be done in case the skin lesions are thicker and the symptoms are greater.


Corticosteroid creams or ointments:

In order to help improve the appearance of the lesions and speed their disappearance, a person may be prescribed topical corticosteroid creams, such as clobetasol propionate. They may be suggested to cover the cream with an adhesive patch or bandages, depending on the thickness of the lesions and the strength of the cream. Covering the steroid cream usually makes it more potent.



Cryotherapy usually lasts from just a few seconds to one minute. The lesions are frozen in this therapy by applying liquid nitrogen to the affected area with a cotton-tipped applicator or a small instrument that is designed especially for applying extreme cold, such as a cryoprobe or a spray device. The liquid nitrogen will freeze the lesions and help remove them, stimulating new growth of cells in the skin.



In some severe cases of generalized granuloma annulare a person may be recommended psoralen plus ultraviolet A (PUVA), which is a special kind of ultraviolet light therapy. In this treatment, exposure to ultraviolet light (phototherapy) is combined with drugs called psoralens, which will help make the skin more receptive to the effects of ultraviolet light.


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