Diagnosed and treated at Dermatology Associates of Atlanta
Granuloma annulare is a skin condition that is characterized by a rash of small red dots arranged in the shape of a ring. In some patients, the rash may be itchy, but granuloma annulare (or GA) typically does not cause any other symptoms and is not contagious. Still, it is often mistaken with a fungal infection called ringworm, which causes a ring-shaped rash as well but the ring is more solid, rather than dotted. Overall, GA is a benign condition that primarily only affects patients in a cosmetic way.
There are several subtypes of granuloma annulare, but the three primary subtypes include:
- Localized Granuloma Annulare – The rash only appears in a small area, usually the hands, feet, wrists, or ankles. This subtype is the most common, and it is particularly prevalent in young adults.
- Generalized Granuloma Annulare – The rash covers a more significant amount of the body, usually the trunk, arms, and/or legs. This subtype affects about 15% of granuloma annulare patients, mostly adults, and it is more likely to itch.
- Subcutaneous Granuloma Annulare – The rash is actually underneath the skin, appearing as a ring-shaped series of firm, small, usually painless bumps under the skin. This subtype is most common in young children, and it is generally focused on the hands, shins, and/or scalp.
There are a few other subtypes of granuloma annulare that are very rare, such as perforating granuloma annulare and arcuate dermal erythema, but the overwhelming majority of patients with GA fall into one of the three main subtypes above.
Granuloma annulare is unique because, while the medical community knows that it doesn’t generally cause any health problems, its actual cause is unknown. It does appear to have a genetic link, and research has supported the theory that the condition can have a number of different triggers which vary from one patient to the next. Some of the apparent triggers include animal or insect bites, certain infections, tuberculosis skin tests, and other minor injuries to the skin. It also seems to occur more in patients with type I diabetes and, to a lesser extent, patients with thyroid disease.
The first step toward relief from granuloma annulare is an accurate diagnosis. While this may be possible with a visual exam alone, in most cases one of our board-certified dermatologists or physician assistants will take a biopsy to confirm.
Most cases of granuloma annulare actually go away on their own without the need for skin treatments. However, this can take up to two years or more, so for patients who want to speed up the process, there are a number of available treatments:
- Topical creams or ointments with corticosteroids
- Corticosteroid injections
- Cryotherapy (freezing the lesions)
- Laser treatments or light therapy
- Oral medications (though this is generally only used for severe cases with rashes that are widespread)
Every case of granuloma annulare is unique, so your treatment plan should be customized to fit your specific needs. To find out the best way to treat your granuloma annulare, schedule a consultation at Dermatology Associates of Atlanta.
While the exact causes of granuloma annulare aren’t known, we do know that it is not contagious. Still, some rashes with a similar appearance are contagious, so it’s always best to visit one of our dermatologists or physician assistants to get an accurate diagnosis when something new develops on your skin.
This condition can affect people of all ages, sexes, races, and health statuses. However, it is more common in girls and women than in boys and men. Granuloma annulare (GA) is also most common in children and young adults, and it is rare to see it in infants, although different subtypes do affect different age groups. For instance, localized GA primarily affects kids and adults under age 30. Generalized GA, on the other hand, primarily affects patients less than 10 years old and patients between 30-60 years old. Subcutaneous GA mostly affects kids between the ages of 2 and 10.
Each subtype of granuloma annulare is different, but GA does tend to recur several times. It’s a chronic skin condition, so the symptoms can arise and last for months or years before resolving and later resurfacing again. Relapses are more common in generalized granuloma annulare than in localized granuloma annulare, but they’re not truly rare in any of the main subtypes.