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Granuloma annulare

 Granuloma annulare



Overview

Granuloma annulare (gran-u-LOW-muh an-u-LAR-e) is a skin condition that causes a raised rash or bumps in a ring pattern. The most common type affects young adults, usually on the hands and feet.

Minor skin injuries and some medicines might trigger the condition. It's not contagious and usually not painful, but it can make you feel self-conscious. And if it becomes a long-term condition, it can cause emotional distress.

Treatment might clear the skin gradually, but the bumps tend to come back. Untreated, the condition might last from a few weeks to decades.

Types of granuloma annulare

There are five main types of granuloma annulare. It’s possible to develop more than one type of granuloma annulare at the same time.

Localized granuloma annulare. Localized granuloma annulare is the most common form of granuloma annulare. It causes a circular rash on your skin limited to one area.

Generalized (disseminated) granuloma annulare. Bumps develop over a larger area of your skin, like your whole forearm, instead of a smaller, more concentrated rash.

Subcutaneous granuloma annulare. Lumps develop under your skin.

Perforating granuloma annulare. Painful bumps form on your hands and fingers.

Patch granuloma annulare. Flat areas of rash form in patches on your skin.


Symptoms

Granuloma annulare symptoms vary according to what type you have.

Localized granuloma annulare

Symptoms of localized granuloma annulare include:

Small bumps on your skin that appear right before a rash develops.

Circular rash on your skin that may start as small circles that later merge.

The rash may appear red, pink, purple or the same color as your unaffected skin.

Generalized granuloma annulare

Symptoms of generalized granuloma annulare include:

Bumps that appear over a large area of your skin.

Bumps that join to form large, discolored areas.

Subcutaneous granuloma annulare

Symptoms of subcutaneous granuloma annulare include:

Small lumps under your skin.

Lumps that may grow quickly.

Firm, round and painless lumps.

Red, pink or discolored lumps.

Perforating granuloma annulare

Symptoms of perforating granuloma annulare include:

Small, painful, scaly bumps on your hands or fingers.

Itchy or painful bumps.

Bumps that leak fluid.

Widespread bumps that connect to form large rashes.

Patch granuloma annulare

Symptoms of patch granuloma annulare include:

Red, reddish-brown or purple flat areas of rash.

A rash appears in one or more areas on your skin.

Causes

It's not clear what causes granuloma annulare. Sometimes it's triggered by:

Animal or insect bites

Infections, such as hepatitis

Tuberculin skin tests

Vaccinations

Sun exposure

Minor skin injuries

Medicines

Granuloma annulare is not contagious.


Risk factors

Granuloma annulare can be related to diabetes or thyroid disease, most often when you have many bumps all over the body. It may, rarely, be related to cancer, especially in older people whose granuloma annulare is severe, doesn't respond to treatment or returns after cancer treatment.

Diagnosis

Your health care provider may diagnose granuloma annulare by looking at the affected skin and taking a small skin sample (biopsy) to examine under a microscope.

Treatment

Granuloma annulare can clear on its own over time. Treatment might help clear the skin faster than if left untreated, but the condition often returns. The bumps that return after treatment tend to appear at the same spots, and 80% of those usually clear within two years.

Untreated, the condition might last a few weeks or decades.

Treatment options include:

Corticosteroid creams or ointments. Prescription-strength products may help clear the skin faster. Your health care provider may direct you to cover the cream with bandages or an adhesive patch, to help the medicine work better.

Corticosteroid injections. If the skin isn't clearing up with a medicated cream or ointment, your health care provider may suggest a corticosteroid injection. Repeat injections may be needed every 6 to 8 weeks until the condition clears up.

Freezing. Applying liquid nitrogen to the affected area may help remove the bumps.

Light therapy. Exposing the affected skin to certain types of light, including lasers, is sometimes helpful.

Oral medicines. When the condition is widespread, your health care provider might prescribe medicine taken by mouth, such as antibiotics or antimalarials.

Types of Doctor Department : Dermatology


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