Massachusetts General Hospital

Granuloma Annulare

What is granuloma annulare?

Granuloma annulare is a benign skin condition characterized by small, raised bumps that form a ring with a normal or sunken center. The cause of granuloma annulare is unknown and it is found in patients of all ages. The condition tends to be seen in otherwise healthy people. Sometimes it is associated with diabetes or thyroid disease. 

What are the symptoms of granuloma annulare?

The following are the most common signs or symptoms of granuloma annulare. However, each individual may experience symptoms differently:

• Yellowish or skin-colored to red bumps

• One or several rings of bumps on feet, legs, or hands

• The eruptions can be confined to one area (less than 10 lesions) or spread to multiple areas (greater than 10 lesions) 

• Lesions may be present for years 

The symptoms of granuloma annulare may resemble other skin conditions. Always consult your doctor for a diagnosis. You should contact your health care provider if you have a ring anywhere on your skin that lasts more than a few weeks. 

How is granuloma annulare diagnosed?

In addition to a complete medical history and physical examination, diagnosis is usually confirmed with a skin biopsy (removing a small sample of tissue for examination under a microscope).

Treatment for granuloma annulare

Specific treatment for granuloma annulare will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the condition

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

Because granuloma annulare usually causes no symptoms and clears up by itself, you may not need treatment (except for cosmetic reasons). If you do receive treatment, it may include corticosteroids (cream, tape, or injections). Some doctors use liquid nitrogen to freeze the bumps. Other treatments, such as dapsone, retinoids, and niacinamide, may be considered for widespread granuloma annulare. Since these treatments carry the risk of toxicity, a consultation with a dermatologist is usually advised. Most granuloma annulare rashes resolve without treatment within two years; however, it is not uncommon to have new rings appear years later.