Images of Granuloma Annulare (8)
Granuloma annulare is a common skin condition that appears as papules (small, solid bumps) that may form smooth, ring-shaped plaques (flat areas that are larger than a thumbnail), often over the joints and the backs of the hands. The cause is not known, and most episodes of granuloma annulare clear up after a few years, with or without treatment.
Who's At Risk?
Although granuloma annulare can occur in people of any race / ethnicity and at any age, it is most commonly seen in children and young adults. Females are slightly more likely than males to develop granuloma annulare.
Signs & Symptoms
Granuloma annulare occurs most frequently over the joints or in areas that experience mild injury. The most common locations for granuloma annulare include:
- The backs of the hands and tops of the fingers.
- The tops of the feet.
- Around the elbows.
- Around the knees.
However, other areas of the skin may also be affected. The lesions of granuloma annulare are usually found in the same areas on both sides of the body (symmetrically).
Granuloma annulare appears as papules that may occur singly or in groups and that may form ring-shaped plaques. The center of the plaque may be lighter or darker than your normal skin color. Healed lesions of granuloma annulare do not leave scars.
Granuloma annulare does not usually have any symptoms, although in some individuals, the lesions may be itchy.
Rarely, granuloma annulare may be widespread, known as generalized granuloma annulare. Generalized granuloma annulare tends to occur in adults aged 30 and older. The condition may consist of 1-2 mm papules that appear on the arms, legs, and upper trunk.
Granuloma annulare may be skin-colored in skin of any color; it may appear pink, light brown, red-brown, or light purple in lighter skin colors; or it may be pink, brown, or purple in darker skin colors.
Because granuloma annulare is usually asymptomatic, no self-care measures are generally needed. If the lesions are itchy, though, an over-the-counter cortisone (eg, Cortaid) cream may be helpful.
If the diagnosis of granuloma annulare is not obvious, a dermatologist may want to perform a skin biopsy.
Once the diagnosis of granuloma annulare is confirmed, you and your medical professional may decide not to treat it, as many cases of granuloma annulare clear up within 2 years, even without treatment.
If the lesions of granuloma annulare cause discomfort or are widespread or cosmetically bothersome, your medical professional may try one of the following:
- A prescription-strength steroid cream
- Steroid injections directly into the lesions or freezing with liquid nitrogen (cryotherapy). In darker skin colors, these treatments may leave an area of lighter skin color.
Generalized granuloma annulare is more stubborn, with fewer cases of spontaneous resolution and more recurrences. In addition, other treatments may be used:
- Oral steroids, such as prednisone (Rayos)
- Ultraviolet light
- Other oral medications such as dapsone, hydroxychloroquine (Plaquenil), or isotretinoin (Amnesteem, Claravis)
If you have bumps or ring-shaped lesions on your skin for more than a few weeks, it is a good idea to have them evaluated by a dermatologist or another medical professional.
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James WD, Elston D, Treat JR, Rosenbach MA. Andrew’s Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2019.
Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology. 9th ed. New York, NY: McGraw-Hill Education; 2019.
Paller A, Mancini A. Paller and Mancini: Hurwitz Clinical Pediatric Dermatology. 6th ed. St. Louis, MO: Elsevier; 2022.
Last modified on February 28th, 2023 at 3:47 pm