Granuloma annulare (gran-u-LOW-muh an-u-LAR-e) is a skin condition that causes raised reddish or skin-colored bumps (lesions) in a ring pattern. The bumps are usually on the hands and feet.
Minor skin injuries and some drugs might trigger the condition. Different types affect adults and children.
The lesions usually disappear on their own within two years without treatment. But if you're bothered by how your skin looks or feels, your doctor can prescribe medications that can speed the disappearance of the condition.
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 are circular or semicircular, with a diameter up to 2 inches (5 centimeters). The reddish or skin-colored bumps occur most commonly on the hands, feet, wrists and ankles of young adults.
- Generalized. Less commonly, adults experience this type, which causes itchy, reddish or skin-colored bumps on most of the body, including the trunk, arms and legs.
- Under the skin. A type that usually affects young children is called subcutaneous granuloma annulare. It produces small, firm lumps under the skin, instead of a rash. The lumps form 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.
It's not clear what causes granuloma annulare. Sometimes it's triggered by:
- Animal or insect bites
- Infections, such as hepatitis
- Tuberculin skin tests
- Sun exposure
- Minor skin injuries
Granuloma annulare is not contagious.
Granuloma annulare is occasionally associated with diabetes or thyroid disease, most often when lesions are numerous or widespread. 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.
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.
Treatment usually isn't needed for granuloma annulare. Most bumps disappear in a few months and rarely last more than two years. But if you're bothered by how your skin looks or feels, ask your doctor about treatment, which can help them disappear faster.
Treatment options include:
- Corticosteroid creams or ointments. Prescription-strength products may help improve the appearance of the bumps and help them disappear faster. 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 aren't clearing up with topical treatment, your doctor may suggest a corticosteroid injection. Repeat injections may be needed every six to eight weeks until the condition clears up.
- Freezing. Applying liquid nitrogen to the affected area may help remove the lesions.
- Light therapy. Exposing the lesions to certain types of light, including lasers, is sometimes helpful.
- Oral medications. In severe cases, especially when the lesions are widespread, your doctor might prescribe drugs taken by mouth, such as antibiotics, antimalarials or drugs used to prevent immune system reactions.
Preparing for an appointment
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?