Granuloma Annulare is a very common skin disease in which histiocytes, a type of immune cell, deposits in the dermis and subcutaneous tissue to produce indurated red plaques with central clearing that I encounter frequently in my The Woodlands dermatology and Conroe dermatology offices. Initially, Granuloma Annulare begins as small red papules that spread outwardly in an annular (circular) configuration. Granuloma Annulare can occur anywhere on the body and the cause is idiopathic with usually no underlying internal association. Patients of any age can be affected by Granuloma Annulare but it does have a female preponderance of 2:1. In many patients, Granuloma Annulare spontaneously resolves and will leave hypopigmentation or hyperpigmentation that is temporary. In some cases, Granuloma Annulare resolves with a permanent atrophic scar. In some patients, a skin biopsy of Granuloma Annulare can result in the resolution of the biopsied plaque. Treatment involves intralesional kenalog (steroid) injections into the indurated Granuloma Annulare lesions, which I perform every 4-6 weeks until the plaques are resolved.
