Patient education: Granuloma annulare (The Basics)

What is granuloma annulare? — Granuloma annulare is a skin condition that can cause a raised, circle-shaped rash. The rash might be red-brown, pink, or skin-colored. There are 2 main types of granuloma annulare:

●Localized – The rash affects only 1 part of the body. This type of granuloma annulare is much more common.

●Generalized – The rash affects more than 1 part of the body. This type of granuloma annulare is less common.

The condition can last for a while. Sometimes, the localized type of granuloma annulare goes away by itself within 2 years.

Granuloma annulare can happen in children and adults. Doctors don't know what causes it.

What are the symptoms of granuloma annulare? — Symptoms depend on the type of granuloma annulare.

Localized granuloma annulare most commonly causes 1 or more circle-shaped areas of raised skin that are not scaly (picture 1 and picture 2 and picture 3). The rash might be red-brown, pink, or skin-colored. Localized granuloma annulare usually affects the wrists, ankles, backs of the hands, and tops of the feet. It is not usually itchy.

Generalized granuloma annulare can cause different types of rashes and skin symptoms. Most commonly, it causes many red, raised, circle- or arc-shaped areas on different parts of the body (picture 4). This rash is sometimes itchy.

In some people, granuloma annulare can look different. For example, granuloma annulare can also look like little bumps on the skin or a large bump under the skin.

Will I need tests? — Not always. Your doctor or nurse might be able to tell if you have this condition by doing an exam and looking at your rash.

If your doctor or nurse is not sure whether you have granuloma annulare, they might scrape your skin and look at the scrapings under a microscope. This test helps tell whether you have an infection that can look like granuloma annulare.

Some people have a test called a skin biopsy. For this test, a doctor takes a small sample of skin from the rash. Then, another doctor looks at it under a microscope.

How is granuloma annulare treated? — Treatment depends on the type of granuloma annulare you have and how bothersome your symptoms are.

If your rash is not itchy or bothersome, you probably do not need treatment. Your rash will most likely go away by itself over time.

If your symptoms bother you or you don't like how the rash looks, there are different treatments that might help.

Treatment for localized granuloma annulare can include:

●Steroid ointments or creams that go on the rash – These medicines help reduce inflammation and itching.

●Shots of steroid medicines that go into the rash

Treatment for generalized granuloma annulare can include:

●Steroid ointments or creams that go on the rash

●Light therapy – For this treatment, your doctor uses a machine that gives off a special type of light.

●Steroid pills

●Other types of medicines

Will my rash return? — In some cases, the rash returns after treatment.

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