How To Detect And Treat Granuloma Annulare

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By Gary L. Dockery, DPM, FACFAS

   Granuloma annulare (GA) is a benign inflammatory, self-limiting granulomatous dermatoses characterized by a variable clinical presentation of dermal and subcutaneous lesions. Although this condition may occur at any age, it is predominantly a disease of children ranging in age from 2 to 10 and adults who are younger than 30. GA is very common in young females as they are twice as likely to be affected than males. Foot involvement occurs in more than 70 percent of all patients with GA and hand involvement occurs in 60 percent of patients.    The lesions may spontaneously resolve in three months to many years, with the average remission occurring two years after onset. Recurrences are common but newer lesions tend to resolve sooner than the original lesions.    The cause of GA is unknown but traditionally has been hypothesized to be related to insect bites, sun exposure, viral infections, diabetes, thyroiditis and certain medications such as antibiotics, antiinflammatory agents and oral contraceptives. However, none of these suggested etiologic factors has been confirmed. Researchers have also proposed the possibility of a hereditary component in some cases but, again, the evidence is weak because of the low numbers of documented cases.

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