GRANULOMA ANNULARE, NODULAR

By Gary M. White, MD

Nodular Granuloma Annulare


See also granuloma annulare.

Nodular, subcutaneous or deep granuloma annulare (GA) is an uncommon variant that most commonly occurs on the extremities and scalp of children.

Clinical

Asymptomatic dermal or subcutaneous nodules are seen. Rarely, sterile prurient drainage may occur. The extremities are most commonly affected, but lesions in the scalp may also be seen. In a variant affecting young women, the lesions are about joints and the term juxta-articular granuloma annulare has been suggested [Am J Dermatopathol 2005:27:1-5].

Differential Diagnosis

Cutaneous nodules with granulomatous inflammation on biopsy brings up a large list of possibilities, including infection, cutaneous Crohn's disease, and rheumatoid nodules.

Treatment

No treatment is needed. They tend to resolve spontaneously over 1-4 years. IL steroid may be done.

Additional Pictures

Nodular Granuloma Annulare

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