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GRANULOMA ANNULARE
GRANULOMA ANNULARE
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GENERAL INFORMATION
DESCRIPTIONGranuloma annulare is a chronic skin disorder characterized by lesions that appear in the shape of a ring. This is not malignant or contagious. The skin on the bottoms of feet and backs of fingers, and on the hands, arms, elbows, legs, and knees is involved. Granuloma annulare can affect all ages but is most common in children (4 to 12 years).
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications, which may include injections of steroid medications into lesions.
SIGNS & SYMPTOMS
Papules (small raised bumps on the child's skin) with the following characteristics:
Papules have a domed or slightly flat shape, 3mm to 6mm in diameter.
Papules are non-scaling.
Papules are pink or violet. Those on the lower extremities are darker than ones on other parts of the child's body.
Papules don't itch or hurt the child.
Multiple papules cluster in a ring. Ring diameters range from 1cm to 10cm. Papules around the ring border are close but don't grow completely together. This gives the border a beaded appearance. The ring's center is often darker than the edge. Ringed lesions change in size and shape over a period of several weeks to 6 months.
CAUSES
Unknown.
RISK FACTORS
Injury to the child's skin, including sunburn.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should avoid injury to the skin. Protect the child's skin from sunburn with sunscreen or clothing.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Biopsy (See Glossary) to confirm diagnosis.
POSSIBLE COMPLICATIONS
Papules and nodules occasionally ulcerate.
Body temperature may rise if a large part of the child's body is covered with plastic dressing (see TREATMENT). If fever occurs, stop treatment.
PROBABLE OUTCOME
Spontaneous recovery within 2 years, but therapy hastens recovery.
TREATMENT
HOME CAREProtect involved areas from injury.
MEDICATION
Your doctor may prescribe topical steroids with occlusion to hasten your child's healing. To use steroids:
Gently rub a small amount of the steroid drug into the affected area.
Reapply a small amount.
Cover the affected area with clear kitchen plastic wrap. If your child's skin becomes dry and itchy, provide additional moisture by covering the affected area with a damp, clean cloth before applying the plastic wrap. You may also soak the affected area briefly in water after applying medicine to the child.
Ask your doctor how often to change the plastic dressing.
Reapply medicine every time you change the plastic dressing.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes.
CALL YOUR DOCTOR IF
Your child has symptoms of granuloma annulare.
Lesions ulcerate.
New lesions occur during treatment.
Signs of infection, such as redness, swelling, pain, or tenderness, develop around the child's lesions.
Your child becomes sensitive to the occlusive plastic dressing.
New, unexplained symptoms develop. Steroid drugs used in treatment may produce side effects.
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From Complete Guide to Pediatric Symptoms, Illness & Medications by H. Winter Griffith, M.D. Copyright by Putnam Publishing
Group. Electronic rights by Medical Data Exchange.
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