Granuloma Annulare

1 What is Granuloma Annulare?

Granuloma annulare is a skin condition that consists of the raised red and skin colored bumps which form ring patterns which occur in the hands and feet.

The main cause of granuloma annulare is unknown but it is believed to be triggered by minor skin injuries and other medications. These conditions may also affect both children and adults.

It does not come with itchy or painful patches and hence no treatment is preferred in most cases. They may also disappear on their own with time.

Medications can also be prescribed by your doctor to enhance the speed of disappearance of the lesions’.

2 Symptoms

The signs and symptoms of the granuloma annulare vary with the type of the conditions:

  • Localized form of granuloma annulare is a very common type of the disease.  It forms bumps (lesions) which borders are circular or semicircular shape with a diameter spanning to about 2 inches (5 centimeters). It is often observed on the hands, feet, wrists and ankles of the young adults.
  • The generalized form of granuloma annulare occurs in about 15% of the people and it affects a large portion of the body such as the arms, legs and trunks. It is also often itchy and affects adults. It sometimes occurs under the skin that affects young children and is referred to as sub cutaneous granuloma annulare.  This causes the formation of the pa painless lumps under the skin and may also come as a form of a rash. They occur as small 1.4 inches (or 3.5 centimeters) in diameter and appear on the hands, shins and scalp.

3 Causes

The main cause of granuloma annulare is not known but it has been associated with the following factors: insect or animal bites, infections, and hepatitis, tuberculin skin tests, exposure to the sun, and minor injuries on the skin.

This disease is also known not be contagious. 

4 Making a Diagnosis

The main method of granuloma annulare disease diagnosis can be achieved by examining the affected parts of the skin sample or biopsy microscopically.

5 Treatment

Granuloma annulare does not need treatment in most cases since most of the lesions will disappear naturally after a few months.

They may also not go beyond two years. However, special treatment can also administer as a way of managing the way your skin looks like.

In addition, the doctor may administer; corticosteroids creams or ointments which help improve the appearance of the lesions and increase the rate at which they can disappear.

Corticosteroids injections can also be used when the skin lesions are thicker and symptoms show no symptoms of improving. The lesions can also be frozen by adding liquid nitrogen which will help remove the lesions and promote growth of the new skins.

They can also be exposed to some unique form of light as a way of administering light therapy such as using the laser treatment for some people.

Oral medications can also be used in the form of antibiotics, antimalarials which can be used for boosting the immune system. Use of the drugs may come with some side effects such as lowering the body’s ability to fight disease infections. This will require close monitoring by your medical doctor.

In most cases, some other drugs such as sulfamethoxazole trimethoprim can be used in the prevention of the lung infections. Bisphosphanates can also be used in the prevention of the bone loss as a result of osteoporosis associated with the use of prednisone. Folic acid can be used in the prevention of sores and other form of symptoms that is associated with the depletion of Folate in the body as a result of use of methotrexate.

Other options for treatment may involve the use of plasma exchange which is referred to as Plasmapheresis which entails the removal of the liquid part of blood plasma that contains the diseases producing substances. An infusion of new plasma or protein produced by the liver (albumin) enables the body to generate new plasma. Plasmapheresis can help the kidneys to recover in people suffering from granulomatosis.

Kidney transplant can also be used in the advanced form of the disease so as normal kidney function can be restored. The decision for kidney transplant relies on how badly the kidney had been affected by the disease. 

6 Prevention

Since granuloma annulare might be triggered by skin injuries and medications, you can prevent outbreaks by taking note of any side effects you experience.

It is important to see your doctor for primary care as soon as you see the signs and symptoms. You will probably be referred to a specialist of skin conditions (dermatologists).

You may need to book an appointment for this visit. But before getting to the appointment, you may need to consider trying to make possible questions that one is likely to be asked such as:

  • Did you travel to a new place in the recent past?
  • Do you have pets and have you been in contact with the new animals?
  • Are there family members with the same symptoms?
  • Are there medications or supplements that you have used regularly?

It is also possible that the doctor may have some questions for you. You are likely to be asked about:

  • When the conditions first started?
  • Whether there is any form of discomfort or rash on your body?
  • Have you been treated of skin conditions in the recent past?
  • Is there anything that seems to improve this condition?
  • Do you suffer from any other health related condition?

7 Risks and Complications

There are several complications associated with granuloma annulare.

It has been indicated that granuloma annulare is associated with diabetes and thyroid disease. This is normally the case when the lesions are more distributed and more numerous.