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Granuloma Annulare - Symptoms and Treatment

Granuloma annulare is a long-term ( chronic ) skin disease consisting of a rash with reddish bumps arranged in a circle or ring. Granuloma annulare occurs most often in children and young adults, though it can affect people of all ages. Although the lesions may be unsightly, granuloma annulare usually causes no other signs or symptoms. The cause of granuloma annulare isn't known. Granuloma annulare is usually asymptomatic, but the rash may be slightly itchy. Patients usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands or feet. The bumps are caused by the clustering of T Cells below the skin. Occasionally, multiple rings may be found. Rarely, granuloma annulare may appear as a firm nodule under the skin of the arms or legs. Because granuloma annulare is usually asymptomatic, treatment may not be necessary except for cosmetic reasons. Most lesions of granuloma annulare disappear with no treatment within two years. Sometimes, however, the rings can remain for many years. The appearance of new rings years later is not uncommon.

Granuloma Annulare is a peculiar disorder of the skin. It is frequently confused with a fungus infection (ringworm), but it is not related. Granuloma annulare usually does not itch, and may otherwise go unnoticed, the sizes of the lesions range from one to five centimeters. It appears most often over knuckles and other joints or in places that are subject to frequent, mild injury such as the back of the hands or top of the feet. It is seen most often in older children and young adults. we can say in other world degenerative disease of the dermal connective tissue characterized by the development of erythematous papules or nodules in the pretibial area. Sometimes the diagnosis is not obvious, and other conditions may be considered. In such cases, a small biopsy will help to establish the cause of the rash. The biopsy shows characteristic necrobiotic degeneration of dermal collagen surrounded by an inflammatory reaction. The diagnosis of granuloma annulare is usually based on the appearance of the skin lesions. In some instances, especially in the less common types, a skin biopsy helps to prove the clinical diagnosis, A urine test for sugar is often performed too, as there is a slightly increased risk of diabetes for those with the less common, widespread type of granuloma annulare. Treatment may include prescription steroid creams or ointments. Troublesome patches may improve using steroid creams or ointments, or occasionally steroid injections into the rings, but this is not always the case and such treatment is not recommended in every individual, as there is some risk of thinning the skin. In severe cases, your doctor may recommend other treatments. So far, no treatment has proved uniformly successful. If you have itching from the rash, a moisturizing lotion or cream, such as Vanicream or Sarna, may help.

Causes of Granuloma Annulare

Common Causes of Granuloma Annulare :

  • Granuloma annulare most often affects children and young adults. It is slightly more common in girls.
  • The diagnosis of granuloma annulare is usually based on the appearance of the skin lesions.
  • Some types of granuloma annulare have been linked with diabetes but this is very uncommon in the ordinary type. It usually affects children and young adults.
  • Some drugs also may cause granuloma annular as a side effect. Some of the drugs may include - allopurinol, zalcitabine.
  • Granuloma annular may be spread by insect bites, sun exposure, thyroiditis and herpes zoster virus.
  • Some viral infections are also one of main cause of granuloma annular. Viral Infections such as EBV, HIV, Hepatitis C and malignant conditions are responsible for it.
  • Trauma, tuberculosis, streptococcal infection and collagen vascular disorder may sometimes lead to formation of granuloma annular.

Symptoms of Granuloma Annulare

Some common Symptoms of Granuloma Annulare :

  • Yellowish or skin-colored bumps.
  • Ringed red bumps back of hands, on soles of feet, on arms, on back of lower body part.
  • A skin biopsy may also be necessary to confirm the diagnosis of granuloma annulare.

Treatment of Granuloma Annulare

  • Treatment may include prescription steroid creams or ointments
  • Some physicians may choose to freeze the lesions with liquid nitrogen.
  • Cortisone injections can also be used to treat granuloma annulare. These are more effective than cortisone creams.
  • Sometimes granuloma annulare responds to topical cortisone preparations .
  • Ultraviolet light therapy (PUVA) or oral medications are also very effective in some cases of granuloma annulare.
  • These are very much suitable to get relief from pain and reduce the swelling part of the skin.








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