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Granuloma Annulare Specialist at Dermatology and Skin Health

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What is Granuloma Annulare?  

Granuloma annulare is a skin condition that commonly affects children and young adults. While it’s not a type of skin cancer, it’s safe to say that it’s a chronic disorder characterized by inflammation of the skin. 

It usually appears over the knuckles, joints, and other skin surfaces that are subjected to frequent, mild injury. The rashes can form on the back of the hands, forearms, or top of the feet.  

But unlike the usual rashes, granuloma annulare looks like small, slightly raised bumps on the skin. It appears symmetrical and has a noticeable border around the rash. Oftentimes, these bumps expand and join to form rings. The center of each ring may look somewhat depressed or hollow and slightly pale or light brown. Its appearance is sometimes confused with ringworm or rashes caused by Lyme disease. 

Aside from the skin bumps, granuloma annulare has no other symptoms. It’s not particularly itchy or painful, but it can sometimes feel tender to the touch. The bumps may clear away on their own, but recurrence is very possible, and they can appear on the same spots. Some patients with granuloma annulare may even develop multiple rings on the skin. 

What Causes Granuloma Annulare? 

It’s not clear what causes granuloma annulare and is categorized as an idiopathic skin disease. However, dermatologists say that there are several factors that can trigger the development of skin lesions and raised bumps. Some of the possible causes of granuloma annulare are: 

  • Insect and animal bites
  • Viral infections 
  • Trauma or injury to the skin
  • Sun exposure
  • Thyroid disease
  • Diabetes
  • Human immunodeficiency virus (HIV) 
  • Certain oral medications 
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What Are The Different Types of Granuloma Annulare? 

There are several types of granuloma annulare depending on the size, shape, and position of the bumps on the skin. Some people may show different symptoms of granuloma annulare and develop more than one type at the same time. Here are the common forms of this skin disorder: 

Localized Granuloma Annulare

This is the most common type of granuloma annulare that affects the majority of the patients. The bumps that form usually look circular or semi-round shaped and they have a visible border. The skin patches can appear reddish, pink, violet, or skin-colored. 

Localized granuloma annulare typically affects one area of the body. The common sites where you can see its patches are on the feet, hands, wrists, and sometimes ankles. 

Generalized Granuloma Annulare 

This type is not as common as the localized granuloma annulare but it can still affect a good number of adults. Also known as disseminated granuloma annulare, this usually affects more than one area of the body at the same time. 

They’re typically widespread and they grow to form large skin colored bumps. It can be accompanied by itchy skin and cause general discomfort. It can be seen on the arms, legs, and torso. 

Subcutaneous Granuloma Annulare

This type is usually diagnosed among young children, and it develops under the skin. Unlike the usual raised bumps or rashes, subcutaneous granuloma annulare forms small and firm lumps beneath the skin. They’re usually harmless but they can grow quickly and multiply into clusters of lumps. You can normally locate them on the hands, arms, shins, legs, and scalp.

Perforating Granuloma Annulare

This is a rare disease that develops small, reddish bumps on the hands and fingers. The lesion of perforating granuloma annulare may contain fluid and sometimes leak through the skin. It can also feel painful and itchy. 

This may develop into a widespread granuloma annulare since they can also join and form large patches across the skin. When the bumps and lesions are treated, they may leave a noticeable scar. 

Linear Granuloma Annulare

This is another uncommon form of granuloma annulare that forms bumps or patches that are localized to the fingers. 

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Possible Risk Factors for Granuloma Annulare  

Dermatologists believe that women are more prone to developing granuloma annulare than men. As with any chronic skin condition, frequent stress can be a potential trigger for granuloma annulare. Excess sun exposure and having photo-damaged skin can also increase your risk for developing this skin problem. 

Diagnosis and Treatments for Granuloma Annulare 

As with any consultation, a dermatologist may ask for your medical history and perform a visual examination of the bumps and rashes. A skin biopsy may be necessary to analyze the affected tissue and rule out possible skin infection. Other medical exams such as a blood test or CT scan may also be done to get a proper diagnosis. 

Most of the time, mild cases of granuloma annulare can go away on its own. However, it can take several weeks up to months before it completely clears. For severe granuloma annulare cases that cover a large part of the body, or if you have visible lumps under the skin,, medical treatment will be required. 

Some of the common treatment options for granuloma annulare are: 

  • Topical medications - Corticosteroid creams, isotretinoin, or tacrolimus ointments can help manage inflammation and improve the appearance of the patches and bumps on your skin. 
  • Injections - A dermatologist may also directly apply the corticosteroid to the lesions. Steroid shots can control skin inflammation and clear the skin more quickly.
  • Cryotherapy - Another effective treatment option is to expose the portion of the skin bumps to cold temperature. A specialized medical device is usually used to freeze and destroy the patches which will help prevent them from growing and multiplying.
  • Ultraviolet light therapy - This is a common method to treat most skin conditions like atopic dermatitis, scleroderma, and even granuloma annulare. During this treatment, the affected skin is treated with specialized UVA light. Some doctors may also use a variation of UV light therapy which is photochemotherapy or PUVA. This involves the application of a medication known as psoralen before treating the skin with UVA light.
  • Laser treatment - Lasers can also be helpful in removing the skin patches by reducing the inflammation and stopping its spread all over the body. 

Consult With a Granuloma Annulare Specialist Today at Dermatology and Skin Health

Visit our specialist at Dermatology and Skin Health and get the right treatment before the patches and bumps on your skin get worse. Our team of doctors can help provide accurate diagnoses and recommend the best solution to improve your overall skin condition. Call us today and book a consultation with us.