Granuloma Annulare

Abstract

Granuloma annulare is a common condition with no known cause.Often, people with granuloma annulare have a few red rings (usually with normal-appearing skin in the center) that can show up anywhere on the body but usually appear on the hands and feet. It often is not associated with any symptoms but can be itchy or painful.

Intensively Pruritic Annular Papules on the Extremities of a Middle-aged Woman

“…5 Another differential diagnosis is PGA, which may present as an umbilicated papule with a central crust or hyperkeratotic core on the extremities or trunk with lesions that become pustular or ulcerate; it is a condition more commonly reported in children. 6 Eruptions are usually asymptomatic, although pruritus and pain have been reported. 7 Histologically, PGA is characterized by mucinous collagen degeneration surrounded by palisading granulomas with transepithelial elimination of altered collagen.…”

“…7 Histologically, PGA is characterized by mucinous collagen degeneration surrounded by palisading granulomas with transepithelial elimination of altered collagen. 6 In diagnosing EPPP, it is also important to exclude APR, which commonly presents as papular, vesicular, and purpuric lesions. 8 Most of the lesions follow a course similar to the classic form of pityriasis rosea.…”

Successful Treatment of Granuloma Annulare with Thin-Layered Co2 Laser Ablation

“…Due to the lack of understanding the pathogenic mechanisms of GA, effective treatment is limited. Research evidence suggests attempts in treating GA with PDL, Er: Glass, Fractionated Thermolysis, and excimer laser are being made [3,[6][7][8][9]. In our opinion, PDL is not a very successful method of treating GA, for this particular laser is pulsed and may lead to vessel coagulation which would delay epithelialization processes.…”

“…Here we present 2 of a total of 9 typical clinical cases of GA successfully treated with thin-layer CO 2 laser ablation. A common treatment of GA is an intralesional steroid injection, in order to decrease the inflammation in the spot area, topical steroids might also be prescribed [3]. Both patients, in presented below cases, have already undergone such therapy with variable or no results, which has led to distrust of treatment and motivation to seek other treatment alternatives.…”

“…Besides to its localized form, there are other variants including generalized GA, disseminated papular GA, atypical generalized GA, subcutaneous, and perforating GA [2]. Even without treatment, the condition will improve; in more of half of the patients lesions regress spontaneously, and therefore therapeutic minimalism is the general approach [3,4]. In some cases however, the disease persists for years.…”