Granuloma anulare

Definition

The so-called granuloma anulare is a benign skin change that occurs mainly in adolescents and young adults. It is mainly women who are affected. In general, it is a rare disease that particularly affects the backs of the hands and feet.

Typical are nodular, circularly arranged skin changes, which are raised above the skin level. The skin-colored skin changes, also known as papules, cause neither itching nor pain. They are asymptomatic and spread centrifugally, i.e. from the inside to the outside.

They heal from their center, so that they temporarily show a small crater. The cause of the disease is unknown. A granuloma is generally described as a type of tissue proliferation characterized by the appearance of special cells (epithelial cells, giant cells).

However, why these granulomas develop is not known at this time. Although the backs of the hands and feet are the most common locations, the anular granuloma can also occur in other parts of the body. Treatment of the anular granuloma is not absolutely necessary, as it often recedes by itself. The treatment options available include freezing (cryotherapy) and injection of cortisone (glucocorticoids) into the granuloma.

Causes of the granuloma anulare

The exact causes of the granuloma anulare are not known. Probably several factors contribute to its development. It is striking that diabetes mellitus is observed in more than 10% of patients. A disturbance of the fat metabolism in the form of a high cholesterol or fat level in the blood is even observed in almost half of the patients with an anular granuloma.

Symptoms of anular granuloma

The anular granuloma is noticeable by ring-shaped, coarse nodules of the skin, which are skin-colored to slightly reddish, but usually do not cause itching. They usually appear on the back of the feet and hands, often also above the joints, and can be as large as a coin. In the course of the disease, the papules increasingly spread and can become larger.

Lower legs, forearms, face and the trunk of the body can also be covered by papules. The disease often progresses in phases and is characterized by frequent recurrence. The anular granuloma can appear similar to rheumatic nodules, so it is very important to differentiate between them.

Certain forms of sarcoidosis, a connective tissue disease, should also be excluded. If the papules are locally limited, it should be clarified whether it is a skin reaction due to a foreign body. The symptoms usually disappear on their own and the papules heal without scarring.