Overview

Granuloma annulare (gran-u-LOW-muh an-u-LAR-e) is a skin condition that causes a raised rash or bumps in a ring pattern. The most common type affects young adults, usually on the hands and feet.

Minor skin injuries and some medicines might trigger the condition. It's not contagious and usually not painful, but it can make you feel self-conscious. And if it becomes a long-term condition, it can cause emotional distress.

Treatment might clear the skin gradually, but the bumps tend to come back. Untreated, the condition might last from a few weeks to decades.

Symptoms

The signs and symptoms of granuloma annulare can vary, depending on the type:

  • Localized. This is the most common type of granuloma annulare. The rash borders are circular or semicircular, with a diameter up to 2 inches (5 centimeters). The rash occurs most commonly on the hands, feet, wrists and ankles of young adults.
  • Generalized. This type is uncommon and usually affects adults. It causes bumps that form a rash on most of the body, including the trunk, arms and legs. The rash might cause discomfort or itchiness.
  • 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 health care provider if you develop a rash or bumps in ring pattern that don't go away within a few weeks.

Causes

It's not clear what causes granuloma annulare. Sometimes it's triggered by:

  • Animal or insect bites
  • Infections, such as hepatitis
  • Tuberculin skin tests
  • Vaccinations
  • Sun exposure
  • Minor skin injuries
  • Medicines

Granuloma annulare is not contagious.

Risk factors

Granuloma annulare can be related to diabetes or thyroid disease, most often when you have many bumps all over the body. 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.

Jan. 20, 2023
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  3. Wolff K, et al. The skin in immune, autoimmune, autoinflammatory, and rheumatic disorders. In: Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 8th ed. New York, N.Y.: McGraw-Hill Education; 2017. https://accessmedicine.mhmedical.com. Accessed Dec. 21, 2018.
  4. Ferri FF. Granuloma. In: Ferri's Clinical Advisor 2019. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. Accessed Dec. 21, 2019.
  5. Brodell RT. Granuloma annulare. https://www.uptodate.com/contents/search. Accessed Dec. 21, 2018.
  6. Mangold AR, et al. Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies: A case-control study. Journal of the American Academy of Dermatology. 2018;79:913.
  7. Bolognia JL, ed. Non-infectious granulomas. In: Dermatology. 4th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed June 18, 2021.
  8. Gibson LE (expert opinion). Mayo Clinic. June 18, 2021.

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