DEAR DR. GOTT: I would like to know of any effective treatment for granuloma annulare.
DEAR READER: This is a chronic skin condition that presents with raised red or flesh-colored lumps that generally appear on the hands, feet, knees and elbows. The lesions often disappear within two years without treatment; however, they may reappear at a later time, and the cycle will repeat itself. The skin may itch, but this is uncommon. When the condition becomes widespread, ringlike patterns may appear over the body and itching becomes more common.
Your primary-care physician or a dermatologist can often diagnose the condition through visual examination. When questions remain, a skin biopsy for examination under a microscope might be done, or a KOH test might be considered. This simply involves scraping the skin onto a glass slide for the purpose of collecting dead cells that will ultimately be mixed with potassium hydroxide (KOH) to identify or rule out fungal infection.
Should you choose to treat your granuloma annulare, this might be accomplished through corticosteroid creams, ointments or injections, cryotherapy (freezing) or light therapy. For generalized granuloma annulare, some physicians prescribe topical calcineurin inhibitors. System treatments include hydroxychloroquine, isotretinoin or dapsone. Speak with your physician to determine which treatment might be best. Good luck.