Generalized granuloma annulare is a skin condition of unknown cause, tending to affect women in the fifth and sixth decades, presenting as a diffuse but symmetrical,
papular or annular eruption of more than ten
skin lesions, and often hundreds.[1]: 703
Signs and symptoms
Generalized granuloma annulare is a chronic granulomatous dermatosis that typically affects young adults' distal extremities and manifests as annular grouped
papules.[2] On the trunk and extremities, numerous flesh-colored
papules arranged in an annular pattern are the hallmark of generalized granuloma annulare. These lesions are frequently itchy, in contrast to the traditional presentation.[3]
Causes
A variety of factors, such as infection, sun exposure, medication use, and trauma, appear to play a role in the development of the disease.[4]
Diagnosis
It has been observed that certain laboratory abnormalities exist, such as
hyperlipidemia,
hypergammaglobulinemia, and the presence of circulating
antinuclear antibodies.[5] Histopathologic analysis may show lymphohistiocytic
granuloma-related alterations primarily in the papillary and mid dermis. Palisaded or interstitial patterns, or a combination of the two, may be seen in inflammatory infiltrates.[4]
Treatment
Generalized granuloma annulare is mostly treated with
phototherapy as opposed to oral
steroids, however treatment efficacy is constrained by a high rate of recurrence after stopping treatment.[6]
Epidemiology
Generalized granuloma annulare accounts for up to 15% of
granuloma annulare cases.[3]
^James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier.
ISBN978-0-7216-2921-6.
^Mangold, Aaron R.; Cumsky, Helen J.L.; Costello, Collin M.; Xie, Daniel Y.; Buras, Matthew R.; Nelson, Steven A.; DiCaudo, David J.; Sekulic, Aleksandar; Pittelkow, Mark R. (2018). "Clinical and histopathologic features of paraneoplastic granuloma annulare in association with solid organ malignancies: A case–control study". Journal of the American Academy of Dermatology. 79 (5). Elsevier BV: 913–920.e1.
doi:
10.1016/j.jaad.2018.06.022.
ISSN0190-9622.
PMID29920319.
S2CID49309849.
^
abSchmieder, Shawn J.; Harper, Chelsea D.; Schmieder, George J. (June 21, 2023).
"Granuloma Annulare". StatPearls Publishing.
PMID29083715. Retrieved February 5, 2024.
^Dabski, Krzysztof; Winkelmann, R.K. (1989). "Generalized granuloma annulare: Clinical and laboratory findings in 100 patients". Journal of the American Academy of Dermatology. 20 (1). Elsevier BV: 39–47.
doi:
10.1016/s0190-9622(89)70005-0.
ISSN0190-9622.
^Lukács, J.; Schliemann, S.; Elsner, P. (February 4, 2015). "Treatment of generalized granuloma annulare – a systematic review". Journal of the European Academy of Dermatology and Venereology. 29 (8). Wiley: 1467–1480.
doi:
10.1111/jdv.12976.
ISSN0926-9959.
PMID25651003.
S2CID20884856.