Granuloma Annularae

A common benign group of papules arranged in an annular fashion.

• Most common among children and young adults

• Associated with diabetes

• Usually on dorsum or sides of fingers (knuckle area), backs of hands, the elbows and knees

Management

• Check urine/blood for sugar

• Give reassurance (they usually subside in a yr or so)

• Cosmetic reasons:

  • – First line: potent topical corticosteroid ± occlusion apply bd for min. 4–6 wks

  • – If ineffective: intradermal injection into the extending outer margin of triamcinolone (equal vol. 10% with N saline). Other long-acting steroids can be used. Can repeat at 6 wkly intervals if effective.

• If disseminated: refer for a systemic therapy.