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    Dr. Rajesh Shah's advice on Granuloma Annulare

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    We have treated 3 cases (2013) but with good results. 
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Granuloma Annulare

What is Granuloma Annulare?

Granuloma Annulare is a rare skin disease, which is long-standing (chronic) where you find skin rash in the form of red bumps arranged in the form of a circle or a ring. It is considered to be autoimmune; though, the exact cause is not yet understood. Overproduction of white blood cells (leucocytes) which gather at some places forming the ring shape rash in this disease.

Causes of Granuloma Annulare:

The exact cause for Granuloma Annulare is not understood. The underlying process is known to be auto-immune in nature. It is often associated with other auto-immune diseases in the patient or in immediate family members, such as diabetes, under-active thyroid, Systemic Lupus, Cancer. Injury to the skin, some allergy (such as gluten) or tetanus vaccine may trigger this disease at times. It is more common in females as compared to males. It can occur at any age.

Types of Granuloma Annulare:

The following clinical variants are recognized.

  • Localized Granuloma Annulare: the localized variant is the most common form. It occurs most commonly on the hands, feet, wrist, and ankles of young adults. Skin colored bumps occur generally on the joints.
  • Generalized Granuloma Annulare: it is predominantly found in adults. The rashes involve a large area of the body including trunk and extremities. They are more likely to be itchy.
  • Deep or Subcutaneous Granuloma Annulare: it is seen most often in children. It favors scalp margins, fingertips and shins. They form a lump below the skin which is rubbery in feel instead of a rash.
  • Perforating Granuloma Annulare: this form is very rare. They are usually localized on the dorsal of hands and fingers. They leave a scar on healing.

Symptoms of Granuloma Annulare:

The most prominent symptom includes bumpy skin rash, reddish eruptions, circular rash with mild itching. Patients usually notice a ring of firm bumps over the back of forearms, hands, and feet. These papules start as small pimple looking bumps, which spread over time. Occasionally multiple rings may join into one.

Diagnosis of Granuloma Annulare:

It is clinically diagnosed because of its characteristic appearance. You may need a skin biopsy to confirm the diagnosis.

Future (Prognosis) of Granuloma Annulare:

If not treated, it may turn out to be self-limiting in about two years; or may last even more. Since it is a result of underlying autoimmune disease, it is better treated internally.

Treatment for Granuloma Annulare:

  • Conventional medications: Topical (local), oral or injectable cortisone is administered for Granuloma Annulare. The disease may return once the effect of the medicine is over. They may also use liquid nitrogen to freeze the bumps. Other treatment includes antibiotics and ultraviolet therapy.

  • Homeopathic treatment: Understanding the cause of Granuloma Annulare as auto-immune, suggesting internal, immunological factors responsible for the disease, homeopathy aims at treating the internal factors by addressing the immune system using oral medicine. At Life Force, we have treated only one case of Granuloma Annulate (by Dec 2013) with encouraging results. We would like to explore more cases in future.

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