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Granuloma annulare

Author
Robert T Brodell, MD
Section Editor
Erik Stratman, MD
Deputy Editor
Abena O Ofori, MD

INTRODUCTION

First described in 1895 [1], granuloma annulare (GA) is a relatively common, often self-limited disorder that can affect both children and adults. Localized GA, which classically presents as a nonscaly, erythematous, annular plaque on the distal extremity is the most common form of GA. The generalized form of GA, which accounts for approximately 15 percent of cases, typically presents with numerous erythematous papules and plaques on the trunk and extremities. Less common forms of GA include subcutaneous, perforating, and patch variants.

Many cases of GA resolve spontaneously within a few years, and treatment is only indicated for patients who have symptomatic lesions or cosmetic concerns. Localized lesions are usually treated with topical or intralesional corticosteroids. Options for the treatment of generalized GA include topical therapies, phototherapy, and systemic medications.

EPIDEMIOLOGY

The exact prevalence of GA is unknown, but it has been estimated that approximately 0.1 to 0.4 percent of new patients who present to dermatologists have GA [2]. Localized GA most frequently occurs during the first three decades of life, although it is not limited to this demographic [3]. In contrast, generalized GA frequently presents during the fourth to seventh decades.

Subcutaneous GA, patch GA, and perforating GA are less common manifestations of this disorder. Subcutaneous GA is most common in children, while the patch type has primarily been reported in adults [4]. Perforating GA is a rare variant that may occur in both adults and children, and appears to have an increased prevalence in the Hawaiian Islands [2,5].

In general, women appear to be at increased risk for GA. Among cases of localized GA, the ratio of females to males is estimated to be approximately 2.5 to 1 [2]. A retrospective study of 100 patients with generalized GA also noted a female predominance; the ratio of females to males was 2.9 to 1 among patients with predominantly annular lesions, and 1.4 to 1 among patients with generalized papular GA [6].

                                    

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Literature review current through: Nov 2016. | This topic last updated: Fri Nov 13 00:00:00 GMT 2015.
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References
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Topic Outline

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