Granuloma annulare (gran-u-LOW-muh an-u-LAR-e) is a skin condition that most commonly consists of raised, reddish or skin-colored bumps (lesions) that form ring patterns — usually on your hands and feet.
No one knows exactly what causes granuloma annulare. But it may be triggered by minor skin injuries and certain medications. Some types of granuloma annulare affect adults, and others typically affect children.
In most cases, granuloma annulare isn't itchy or painful, so no treatment is necessary. The lesions usually disappear on their own within two years. If you're bothered by how your skin looks, your doctor can prescribe medications that will speed the disappearance of the lesions.
The signs and symptoms of granuloma annulare can vary, depending on the variety:
- Localized. This is the most common type of granuloma annulare. The bump (lesion) borders have a circular or semicircular shape, with a diameter up to 2 inches (5 centimeters). It occurs most commonly on the hands, feet, wrists and ankles of young adults.
- Generalized. Up to 15 percent of the people who have granuloma annulare have lesions over a large portion of their bodies — including the trunk, arms and legs. This type is more likely to be itchy and to affect adults.
- Under the skin. A type that usually affects young children is called subcutaneous granuloma annulare. It produces firm, usually painless, lumps under the skin instead of a rash. The lumps are usually less than 1.4 inches (3.5 centimeters) in diameter and appear on the hands, shins and scalp.
When to see a doctor
Call your doctor if your skin develops reddish bumps (lesions) in ring patterns that don't go away within a few weeks.
No one knows exactly what causes granuloma annulare. But in some people, the condition may be triggered by:
- Animal or insect bites
- Infections, including hepatitis
- Tuberculin skin tests
- Sun exposure
- Other minor injury to the skin
Granuloma annulare is not contagious.
Granuloma annulare is occasionally associated with diabetes or thyroid disease, most often when lesions are numerous or widespread.
Your doctor may diagnose granuloma annulare by examining the affected skin. He or she may take a small skin sample (biopsy) to examine under a microscope.
In most cases, no treatment is necessary for granuloma annulare. Most lesions disappear within a few months, and rarely last more than two years. If the appearance of your skin bothers you, your doctor may recommend:
- Corticosteroid creams or ointments. Prescription-strength products may help improve the appearance of the lesions and speed their disappearance. Your doctor may direct you to cover the cream with bandages or an adhesive patch, to increase the effectiveness of this treatment.
- Corticosteroid injections. If the skin lesions are thicker and your symptoms are greater, your doctor may inject corticosteroids directly into the lesions to help them disappear faster.
- Freezing the lesions. Applying liquid nitrogen to the affected area can help remove the lesions and stimulate the growth of new skin.
- Light therapy. Exposing the lesions to particular types of light is sometimes helpful. Certain types of laser treatments also work for some people.
- Oral medications. In severe cases, especially when the lesions are widespread, your doctor might prescribe antibiotics, antimalarials or drugs used to prevent immune system reactions.
You're likely to start by seeing your primary care doctor. He or she may refer you to a specialist in skin conditions (dermatologist).
What you can do
Before your appointment, you might want to list answers to the following questions:
- Have you recently traveled to a new area or spent significant time outdoors?
- Do you have pets, or have you recently had contact with new animals?
- Are any family members or friends having similar symptoms?
- What medications or supplements do you take regularly?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- When did your skin condition first appear?
- Does your rash cause any discomfort? Does it itch?
- Have your symptoms become worse or stayed the same over time?
- Have you been treating your skin condition with any medications or creams?
- Does anything seem to improve — or worsen — your symptoms?
- Do you have any other health conditions, such as diabetes or thyroid problems?