What it looks like and what it is like
A typical lesion begins with a small dense nodule, around which new ones gradually appear, forming a ring with a diameter of one to several centimeters. The ring cushion is raised and firm to the touch, the skin in the center is unchanged or slightly sunken. Color varies from flesh to mauve. In addition to the classic localized form, there is a common variant with multiple foci throughout the body, a subcutaneous form in children in the form of dense painless nodes, and also a perforating form with a slight retraction in the center of the nodules.
- Localized form - one or two rings on the hands or feet
- Common (generalized) form
- Subcutaneous form, more often in children
- Perforated form with plugs in the center of the nodules
- No peeling on the surface
- The center of the ring looks healthy
Reasons and connections
The exact reason is unknown. It is believed that this is a reaction of skin immune cells to a not fully understood trigger, leading to the destruction of collagen in the upper layers of the dermis. Injuries, insect bites, past infections, vaccinations, and sun exposure are discussed. In common forms, disorders of carbohydrate and lipid metabolism are detected much more often, so such patients are recommended to check their blood sugar and lipid spectrum. The disease is not transmitted from person to person and is not related to hygiene.
- Immune reaction of the skin with destruction of collagen
- Injuries and insect bites as a trigger factor
- Association of the common form with diabetes
- Lipid disorders
- Past infections and vaccinations
- Not contagious and not related to hygiene
Symptoms
The main complaint is usually cosmetic: the person is bothered by the appearance of strange rings on the arms or legs. There is almost no itching, no pain, the surface is smooth, no scales are formed, so the lesions do not interfere with everyday life. The rings grow very slowly, over months, and can remain unchanged for a long time. In children, the subcutaneous form looks like dense, moving balls under the skin on the legs, feet, or scalp, which parents often mistake for something dangerous. General health does not suffer.
- Rings and arcs of dense knots
- Flesh, pinkish or lilac color
- No itching or flaking
- Slow growth of lesions
- Localization on hands, feet, elbows, knees
- Dense subcutaneous nodes in children
What examinations are needed
Usually, an examination by a dermatologist is enough: the combination of a ring-shaped shape, a dense ridge and a complete absence of peeling is very typical. To exclude a fungal infection, a scraping is taken from the edge of the lesion and examined under a microscope - this is an important step, because antifungal ointments are useless for granuloma annulare. In unclear cases, a skin biopsy is performed with histology, which gives an accurate answer. For common forms, the doctor recommends checking glucose levels, glycated hemoglobin and lipid spectrum, and, if necessary, refers to a therapist or endocrinologist.
- Examination by a dermatologist and dermatoscopy
- Scraping from the edge of the hearth for mushrooms
- Skin biopsy with histology if in doubt
- Blood glucose and glycated hemoglobin
- Lipid spectrum in the common form
- Consultation with a therapist or endocrinologist as indicated
Treatment
Since the disease is benign and goes away on its own in most people, observation is often chosen for single lesions. If the rash bothers you, the dermatologist prescribes a course of external hormonal agents or injects them directly into the lesion. Sometimes after a biopsy the lesion disappears on its own. For common forms, the doctor selects systemic therapy or phototherapy individually. Antifungal drugs, antibiotics and folk remedies do not work. Separately, there is treatment for diagnosed diabetes or lipid metabolism disorders, which improves skin condition.
- Observation for single lesions
- External hormonal agents as prescribed by a doctor
- Introduction of drugs into the lesion
- Phototherapy and systemic treatment for the common form
- Avoidance of antifungals and antibiotics
- Correction of sugar and lipid levels