Dermatology - Granuloma Annulare

Dermatology - Granuloma Annulare
Granuloma annulare is a frequently occurring, self-limiting, asymptomatic, and persistent skin condition that typically affects children and young adults.

Granuloma annulare has a duration of many months to years and typically does not cause any symptoms, except for cosmetic damage.
Abnormalities
The individual presents with raised, even, glossy, clustered skin lesions and patches, measuring 1-5 cm in diameter. These lesions have a circular or crescent shape with a depressed center and can appear in various colors, including flesh-colored, bluish-purple, or red.
Subcutaneous granuloma annulare is an uncommon and painless condition characterized by the presence of skin-colored nodules that develop in the deep layers of the skin or just beneath it. These nodules can arise either as a single nodule or as many nodules, and are typically found on the fingers and toes. The lesions are primarily found on the back of the hand, fingers, or lower arm. Multiple lesions can manifest on the limbs and torso, or be widespread in nature (papular; in elderly individuals). Subcutaneous lesions are situated in close proximity to joints, palms, soles, and buttocks.

The diagnosis is made based on clinical assessment after excluding more severe disorders. Precise diagnosis is crucial due to its resemblance to more severe illnesses. The differential diagnosis comprises necrobiosis lipoidica, papular sarcoid, lichen planus, lymphocytic infiltration of Jessner, rheumatoid nodules, and subcutaneous fungal infections such as sporotrichosis, tinea, erythema migrans, and lichen planus.

Granuloma annulare is a localized skin illness that does not indicate the presence of an interior disease. Spontaneous remission is typically observed. If the lesions are not causing any disfigurement, then it is possible to consider not pursuing any therapy.
Lesions may heal after undergoing a biopsy procedure. If treatment is sought for cosmetic purposes, the application of glucocorticoids on the skin with occlusion or the injection of triamcinolone at a concentration of 3 mg/mL directly into the affected area are both effective methods.
Cryotherapy with liquid nitrogen is effective in treating superficial lesions, although it may lead to atrophy.
Photodynamic treatment is efficacious for widespread lesions. Systemic glucocorticoids are also efficacious in treating widespread lesions, but recurrences are frequent.