Overview

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

Minor skin injuries and some drugs 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 (chronic) condition, it can cause emotional distress.

Treatment might clear the skin gradually, but the lesions 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 bump (lesion) borders are circular or semicircular, with a diameter up to 2 inches (5 centimeters). The lesions occur 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 doctor if you develop a rash or bumps (lesions) 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
  • Drugs

Granuloma annulare is not contagious.

Risk factors

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.

July 13, 2021
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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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