Granuloma annularae

Question 1

Features

Answer 1

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

Question 2

Management

Answer 2

Check urine/blood for sugar

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

Cosmetic reasons:

1. First line: potent topical corticosteroid ± occlusion apply bd for min. 4–6 wks
2. 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 or liquid nitrogen wkly.

If disseminated: refer for a systemic therapy.