Granuloma annulare

Granuloma annulare is a common inflammatory condition of unknown cause. It typically presents as an annular plaque, ranging from skin colour to shades of red or violet. For a photo of granuloma annulare, see here. The margin often feels beaded. Localised granuloma annulare can occur anywhere on the body but most commonly on the back of the hands and the top of the feet. Generalised granuloma annulare is more common in patients with diabetes. It is frequently misdiagnosed as tinea. Diagnosis is confirmed with biopsy; the appearance on biopsy is characteristic. Refer for dermatologist advice if the diagnosis is unclear.

Figure 1. Granuloma annulare

Note: Reproduced with permission from the A-Z of Skin [digital]. Australasian College of Dermatologists. Sydney. https://www.dermcoll.edu.au/

Lesions usually clear spontaneously, but may persist for months or years. Most localised lesions resolve without treatment. However, treatment is required when the condition:

  • persists for months
  • is cosmetically unappealing or tender
  • interferes with normal function (eg on a finger).

For initial therapy of localised lesions, use a topical corticosteroid with or without occlusive dressings. Use:

1betamethasone dipropionate 0.05% ointment topically, twice daily for a minimum of 4 to 6 weeks betamethasone dipropionate betamethasone dipropionate betamethasone dipropionate

OR

1mometasone furoate 0.1% ointment topically, twice daily for a minimum of 4 to 6 weeks. mometasone furoate mometasone furoate mometasone furoate

If therapy is not effective, or if granuloma annulare is generalised or extensive, seek dermatologist advice.