Granuloma Annulare

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Contents 1 Introduction 2 Etiology 3 Epidemiology 4 Pathology 5 Clinical-manifestations 6 Laboratory 7 Management 8 More General Terms 9 Additional Terms 10 References

Introduction

• Self-limited asymptomatic dermatosis characterized by papules in an annular arrangement, commonly arising on the dorsal aspect of the hands & feet, elbows & knees, but may appear on other surfaces including the trunk.

Etiology

• unknown
• may be associated with diabetes mellitus

Epidemiology

• children & young adults
• female:male ratio 2:1

Pathology

• chronic inflammatory & histiocytic infiltration of superficial & mid dermis
• reversible necrobiosis of connective tissue surrounded by palisading histiocytes & multinucleated giant cells
• inflammatory reaction around blood vessels

Clinical-manifestations

• generally asymptomatic
• smooth papules or plaques, skin-colored, erythematous or violaceous
• annular or ring-like arrangement

Laboratory

• microscopic examination of KOH preparation of skin scraping

Management

• patient education

• spontaneous resolution in 75 of cases within 2 years
• recurrence is common (40%)

• pharmacologic agents

• topical glucocorticoids
• intralesional triamcinolone 3 mg/mL

• cryotherapy with liquid nitrogen
• PUVA phototherapy

More General Terms

• skin disease (dermatologic disorder, dermatopathy, dermatosis)
• granuloma

Additional Terms

• diabetes mellitus
• necrobiosis lipoidica diabeticorum [NL]

References

Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 272-73

granuloma annulare (GA)