Granuloma Annulare

What is granuloma annulare?

Granuloma annulare is a harmless type of skin rash. The rash is most often discolored and raised, and roughly in the shape of a ring. The rash may be on just one part of the body. Or it may appear on more than one area of the body and become widespread (generalized). In some cases, it may itch. The rash can last for up to 2 years before it goes away on its own. It's not spread from person to person (contagious).

What causes granuloma annulare?

Researchers don’t yet know what causes it. It may be linked to other illnesses, genes, or other skin injury or conditions. Some researchers think it may be linked to diabetes, but that has not been proven.

Who is at risk for granuloma annulare?

The rash can occur in anyone at any age. But it happens more often in women than men.

What are the symptoms of granuloma annulare?

Symptoms can occur a bit differently in each person. They can include firm bumps of skin roughly in the shape of a ring. The ring or rings may be red, yellow, brown, or skin-colored. You may have several rings just on your feet, wrists, or hands. This is called a localized rash. Or you may have more rings on other areas of your body, such as your torso, arms, and legs. This is called a generalized rash. This type may also feel itchy.

The symptoms of granuloma annulare can be like other health conditions. Make sure to see your healthcare provider for a diagnosis.

How is granuloma annulare diagnosed?

Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. You may need to see a skin doctor (dermatologist). You may also have tests, such as:

• Skin scraping. The healthcare provider scrapes the top of your skin with a small tool. The scraped tissue is examined with a microscope. This can show if the rash is from an infection. This may be done to rule out fungus. Fungus can look similar on the skin.

• Skin biopsy. A small piece of skin is cut out and removed and sent to a lab. The skin is examined for other types of problems that may cause a rash.

How is granuloma annulare treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is.

You may not need treatment. The rash will likely go away on its own within 2 years. If the rash bothers you with itching or cosmetic appearance, it may be treated with any of these:

• Corticosteroid medicine. This can ease inflamed tissue and reduce itching. It may be used as ointment or cream on the skin. It can also be injected into the rash, or taken by mouth as a pill.

• Phototherapy. This treatment uses a machine to direct a special type of light at the rash.

• Other treatments. Liquid nitrogen or other medicines may be used to lessen the rash. If the rash is widespread, you may need medicine taken by mouth (oral), such as hydroxychloroquine.

Granuloma annulare is hard to treat. You may need to try a few treatments to find one that works.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What can I do to prevent granuloma annulare?

Researchers don’t know how to prevent granuloma annulare.

How to manage granuloma annulare

Granuloma annulare can last for up to 2 years. But you can manage symptoms by working with your healthcare provider to create a treatment plan. In some cases, the rash may come back again.

When should I call my healthcare provider?

Call the healthcare provider if you have:

• Symptoms that don’t get better, or get worse

• New symptoms

Key points about granuloma annulare

• Granuloma annulare is a harmless type of skin rash. The rash is most often red and raised, and roughly in the shape of a ring.

• The rash may be on just one part of the body. Or it may appear on more than one area of the body. In some cases, it may itch.

• The rash can last for up to 2 years before it goes away on its own. It is not spread from person to person (contagious).

• You may have a skin biopsy. A small piece of skin is cut out and removed and sent to a lab.

• You may not need treatment. The rash will likely go away on its own within 2 years. If you need treatment, it may include corticosteroid medicine.

• In some cases, the rash may come back again.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.