Background

Granuloma annulare is a delayed hypersensitivity reaction to some component of the dermis.

Inflammation is mediated by tumour necrosis factor alpha (TNFα). The reason that this occurs is unknown.

Causes of Granuloma Annulare

Disseminated Granuloma Annulare is more prevalent in diabetes, hyperlipidaemia, lymphoma, HIV infection, solid tumours

Localised granuloma annulare is sometimes associated with autoimmune thyroiditis but it does not clear up with thyroid replacement.

Features of Localised Granuloma Annulare

• Annular plaque
• Skin colour violet red
• Margin feels beaded
• Most common sites back of hands and feet
• Frequently confused with tinea

Natural history of Localised Granuloma Annulare

Usually clears spontaneously within a few months or years

Treatment of localised granuloma annulare

• Betamethasone Dipropionate 0.05% ointment BD 4-6 weeks
• Mometasone Furoate 0.2% ointment bd 4-6 weeks
• With or without occlusion