Q: I have been told by my skin doctor after a biopsy that I have granuloma annulare. It does not itch or bother me so we are taking a watch and see approach. My concern is what caused it. It started in January of this year. I have it in my arm folds, under my arms at the pits, and have large spots starting in the groin area and spreading 8 inches long and 6 inches wide. That is the worst.
I started taking 10 mg of pravastatin, OPC3 and powdered calcium put out by Market America. I had a cortisone shot in my knee. I’m 73 years old.
My question is, do you think any of the drugs could have caused it?
A: Granuloma annulare is a chronic skin disease that presents as a rash with red or flesh colored bumps arranged in a circle on the outside of the ring on the hands, feet, or backs of the forearms; however, it can spread to other parts of the body, as well. Some forms occur more frequently in adults, while other forms are seen in children and young adults, with females being slightly more likely to acquire it than males. The most common type seen is localized. The lesions will still have a circular or semi-circular shape, with a diameter up to two inches. The generalized type will have lesions over a large portion of their bodies, including the trunk area, arms and legs. This type is more likely to itch and is also more likely to affect adults rather than younger individuals. The subcutaneous form presents as a firm lump less than 1 ½ inches and will not have the classic circular appearance under the skin without rash.
While the cause for this condition is unknown, triggers may include exposure to the sun, minor skin injury, an insect bite, through a vaccination or TB skin test, or because of infection. While there are reports of an association between granuloma annulare and diabetes, malignancy and thyroid disorders, nothing has been proven thus far.
Some individuals will not experience symptoms, while others may have itching and pain.
Granuloma annulare has an appearance of a fungal infection. Therefore, a biopsy and other testing may be used to differentiate between the two conditions. No treatment is necessary unless it is performed for cosmetic reasons. Without treatment, the “rash” will likely disappear on its own in about two years; however, when problems occur, steroid creams and ointments may be prescribed to clear the rash faster. Steroid injections directly into the rings may also be performed. An alternative is to freeze the lesions with liquid nitrogen that will help remove the lesions and stimulate new skin growth. Widespread cases may require ultraviolet light therapy or drugs to suppress the immune system. Lastly, and for severe cases, oral medication designed to prevent immune system reactions in individuals with rheumatoid arthritis or organ transplant patients might be considered.
The pravastatin you have been prescribed is a statin drug to reduce bad cholesterol and triglycerides, while increasing good cholesterol. Powdered calcium helps with the formation and maintenance of bone. There is a probability of itching with this medication. I am unfamiliar with OPC3 except to know it is a supplement sold by Market America. Because it is not FDA approved, I cannot provide an opinion as to whether or not it may have had a role. Cortisone is a steroid that prevents the release of substances within the body that cause inflammation. Frankly, I cannot blame your granuloma annulare on any of the prescribed medications you are taking. However, you can certainly speak withprescribing physician for his or her input. Good luck.
