What Does Granuloma Annulare Look Like?

April 13, 2022

Granuloma annulare on a foot

Have you noticed small bumps on the skin or rashes that form a circle or ring on the skin? You may be suffering from a benign skin condition called granuloma annulare. According to Dr. Carmen Julian of U.S. Dermatology Partners Mueller in Austin, Texas, “If you’ve recently noticed small bumps or rashes on your hands, feet, arms, legs, or trunk, you may be dealing with granuloma annulare. While the appearance of this skin condition can be less than ideal, the good news is that it’s not dangerous. If you notice some of the common warning signs of granuloma annulare, especially if you’re in a higher risk category, you should work with a dermatologist to receive an accurate diagnosis and develop an effective treatment plan.” In this blog, Dr. Julian will answer some common questions that we hear from patients about granuloma annulare, including describing what this common skin condition looks like, so you can recognize the warning signs and know when to reach out to your dermatologist.

What Is Granuloma Annulare?

Granuloma is a rare, chronic, benign skin condition that causes bumps to develop below the skin often in a ring pattern. Because of its rarity, most people haven’t heard of granuloma annulare, and even those who know about this condition aren’t often aware of the common symptoms. Similar to eczema, psoriasis, and rosacea, granuloma annulare is a chronic, inflammatory skin condition. Anyone of any age can develop granuloma annulare, but it’s more common in young adults. This condition is not contagious, and it rarely causes any discomfort

There are four main types of granuloma annulare (with numerous variants):

  • Localized Granuloma Annulare – This is the most common form of the condition. Characterized by ring-shaped rashes and bumps on the skin, usually developing on the feet, legs, hands, and arms.
  • Generalized (Disseminated) Granuloma Annulare – Characterized by bumps and thickened skin called plaques developing on the trunk, arms, and legs.
  • Perforating Granuloma Annulare – Characterized by papules that fill with damaged collagen that discharge from the skin.
  • Subcutaneous Granuloma Annulare – Characterized by deep bumps called nodules that develop on the scalp, shins, or hands.

What Causes Granuloma Annulare?

There is no specific cause of granuloma annulare, but the condition seems to be triggered by skin injuries, including:

  • Insect bites
  • Infections
  • Skin lesions
  • Skin tests
  • Surgical incisions
  • Vaccinations
  • Sunburns and UV damage
  • Skin injuries

In addition to injuries, certain medications seem to increase the risk for developing this condition. While healthy people can develop granuloma annulare, those with thyroid disease and diabetes may be at an increased risk. In patients with diabetes or thyroid disease, there can be more granuloma annulare lesions, and they are frequently widespread over the body. Certain types of cancer and cancer treatments, especially in older adults, may also lead to an increased risk for granuloma annulare, which can be severe and less responsive to treatment.

What Are the Common Symptoms of Granuloma Annulare?

According to Dr. Julian, “Because symptoms of granuloma annulare can look like other chronic skin conditions, it’s important to receive a professional diagnosis from a dermatologist. In most cases, your dermatologist will be able to diagnose granuloma annulare by performing a simple visual examination, but to ensure an accurate diagnosis, we may perform a biopsy to take a closer look under the microscope.” You should schedule a visit with your dermatologist to receive an accurate diagnosis if you notice any of the following common symptoms of granuloma annulare, including:

  • Flesh-colored, yellow, or red bumps that are usually firm
  • Thickened patches of skin called plaques
  • Bumps or rashes that develop in a circular shape
  • Symptoms may be localized (develop in one area) or generalized (spread over multiple parts of the body)

These symptoms of granuloma annulare may be present for weeks, months, or even years. In most cases, the symptoms will resolve on their own in time, but they do often recur.

How Is Granuloma Annulare Treated?

When it comes to treatment options for granuloma annulare, Dr. Julian says, “Symptoms will almost always go away on their own, but lesions will usually come back. When granuloma annulare symptoms return, they typically develop on the same area of the skin. Because granuloma annulare is benign, treatment isn’t always recommended. When treatment is recommended, your dermatologist will focus on reducing healing time and preventing future flare-ups of granuloma annulare. With treatment, most people will see complete clearance of granuloma annulare symptoms after a few years. Without treatment, these lesions may be present or recur over a longer period.”

Before beginning a treatment plan for granuloma annulare, your dermatologist will consider numerous factors, including your overall health, age, the severity of your symptoms, and your treatment and skin health goals. If the dermatologists determine a patient is likely to benefit from treatment, common recommendations for granuloma annulare treatment include:

  • Corticosteroids – Prescription-strength or over-the-counter topical creams and medicated ointments may be used to clear up bumps more quickly. Additionally, corticosteroids injections may be provided to help clear a flare-up.
  • Cryotherapy – Using liquid nitrogen to freeze the lesions can help destroy the damaged skin cells and jumpstart the healing process.
  • Light therapy – Using light waves to cause blood vessels to constrict and reduce any discoloration in the affected area.
  • Laser therapy – Laser waves are used to remove the damaged skin cells and promote healing and healthy cell turnover.
  • Oral medications – For widespread granuloma annulare flare-ups, dermatologists may prescribe oral medications like antibiotics and antimalarials. Biologic medications may also be prescribed to help with immune function. In some cases, oral medications with vitamin A (retinoids) or vitamin B (niacinamide) derivatives can be prescribed.

Schedule a Visit to U.S. Dermatology Partners

If you notice changes in your skin that you believe may be related to granuloma annulare, don’t hesitate to reach out to the U.S. Dermatology Partners team. With locations in numerous states, one of our offices may be near your home. Getting started is simple. You can take just a few moments to complete our online scheduling form. One of our team members will be in touch to finalize the details of your visit.

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