Granuloma annularae, what is it??

Question

Skin condition with raised red bumps, sometimes itchy, sometimes painful to touch.
No known cause or treatment.
What is this skin condition, does anyone know.??????
Not even my dermetologist could tell me exactly what it is.
I started using colloidal silver, and it has made a huge difference.
Hasn't cleared it completely, but looks and feels much better.

Answer 1

Granuloma annulare is a long-term (chronic) skin disease consisting of a rash with reddish bumps arranged in a circle or ring.
Causes, incidence, and risk factors
Granuloma annulare most often affects children and young adults. It is slightly more common in girls.
The condition is usually seen in otherwise healthy people. Occasionally, it may be associated with diabetes or thyroid disease. Its cause is unknown.
Symptoms - Granuloma annulare usually causes no other symptoms, but the rash may be slightly itchy.
Patients usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands or feet. Occasionally, multiple rings may be found.
Rarely, granuloma annulare may appear as a firm nodule under the skin of the arms or legs.

Signs and tests - Your physician may consider the diagnosis of fungal infection when looking at your skin. A skin scraping and KOH test can be used to tell the difference between granuloma annulare and a fungal infection.

A skin biopsy may also be necessary to confirm the diagnosis of granuloma annulare.

Treatment - Because granuloma annulare is usually asymptomatic (causes no symptoms), treatment may not be necessary except for cosmetic reasons.

Very strong topical steroid creams or ointments are sometimes used to speed the disappearance of the lesions. Injections of steroids directly into the rings may also be effective. Some physicians may choose to freeze the lesions with liquid nitrogen.

In severe cases, ultraviolet light therapy (PUVA) or oral medications may be needed.

Expectations (prognosis) - Most lesions of granuloma annulare disappear with no treatment within two years. Sometimes, however, the rings can remain for many years. The appearance of new rings years later is not uncommon.

Answer 2

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Answer 3

The lick sores are best left open to the air. If you have to use a sedative to keep him in the e-collar do it for a few days. They usually heal fast if you can prevent him from licking. Call your vet to see if he'll give you a topical cream to put on the sore spots to stop the itching. Good Luck.

Answer 4

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Answer 5

Granuloma annulare (GA) is a benign inflammatory, self-limiting granulomatous dermatoses that is seen in both adults and children . Females are more commonly affected than males. The lesions may involve skin and/or subcutaneous tissue.
The etiology of GA is unknown. The lesions could be related to insect bites, sun exposure, viral infections, diabetes, thyroiditis, immunoglobulin-mediated vasculitis, and certain medications such as antibiotics, antiinflammatory agents and oral contraceptives. Cases have also been reported in patients with AIDS, sarcoidosis ,hepatitis C infection, Hodgkin's and non Hodgkin's lymphoma, metastatic adenocarcinoma and granulomatous mycosis fungoides.
Clinical variants:
(1) Localized - Children & young adults. Papules & annular or arciform plaques.
Site: Hands, feet, arms & legs.
(2) Generalized - Middle aged and elderly patients. Multiple macules, papules or nodules.
Site: Trunk & limbs.
(3) Perforating - Middle aged & elderly females. Papules & annular plaques. Scaling & crusting with central umbilication may be present.
Site: Dorsa of the hands and feet.
(4) Subcutaneous or deep form - Children & young adults. Solitary or multiple nodules (a few millimeters to several centimeters in size).
Site:  Lower extremities, dorsa of the hands & feet, buttock and scalp.
Histological patterns in Granuloma Annulare:
1.Necrobiotic granuloma
2.Interstitial or 'incomplete' form - Most common
3.Granuloma of sarcoidal or tuberculoid type: Rare
Features of Necrobiotic Granulomas in the dermis:
- Located in the superficial and mid dermis.
- Areas of necrobiosis surrounded by peripheral rim of histiocytes and lymphocytes.
- Multinucleated giant cells (+/-)
- Intervening areas of dermis between the necrobiotic granulomas is normal.
- Central necrobiotic area contains abundant connective tissue mucins which is lightly basophilic in apperance. Mucin stains (Colloidal iron and alcian blue) are useful.
- Small amounts of fibrin may be present as fibrillary eosinophilic material.
- Perivascular infiltrate of lymphocytes in superficial & mid dermis.
- Neutrophils and nuclear dusts are present in some cases.
- Vasculitis may be present near foci of necrobiosis.
Differential diagnosis: Necrobiosis Lipoidica:
Multilayered necrobiosis (stacks of plates) with open ends.
Numerous plasma cells.
Thickened collagen bundles within palisaded granuloma.
Diffuse process present throughout the reticular dermis.
Features of interstitial or 'incomplete' form of granuloma annulare:
- Should be assessed under low power.
- "Busy dermis" - increased number of inflammatory cells in the dermis separated by connective tissue mucin.
- Infiltrate composed of lymphocytes and histiocytes.
- Inflammatory cells are noted around blood vessels and between collagen bundles.
- No well-defined areas of necrobiosis
Differential diagnosis: (1) Interstitial granulomatous drug reaction:  Eosinophils (+) , lichenoid changes at dermoepidermal junction , true necrobiosis is rarely noted .
(2) Interstitial granulomatous dermatitis : Neutrophils, neutrophil fragments, histiocytes, lymphocytes & eosinophils are present , palisades of histiocytes around basophilic collagen fibres. Changes may involve the full thickness of the dermis.
Features of subcutaneous granuloma annulare: (pseudorheumatoid nodule) :  
- Located in the deep dermis, subcutis and rarely deep soft tissue.
- Area of necrobiosis is larger than the superficial type.
- Granulation tissue and lymphoid aggregates may be present near palisaded granuloma.
- Eosinophils are more common in this variant.
Differential diagnosis: - Rheumatoid Nodules: Rheumatoid nodule and subcutaneous granuloma annulare.(Ref A comparative histologic study.Am J Dermatopathol. 1988 ;10(1):1-8.)
Necrobiotic foci contain abundant fibrin. Degenerated bundles of collagen (+/-). Palisade of elongated histiocytes.
Features of disseminated form of granuloma annulare:
- Poorly formed granulomatous foci in the papillary dermis.
- Necrobiosis is not prominent.
Differential diagnosis : Lichen Nitidus : Claw-like acanthotic elongation of rete-ridges at the periphery of the lesion is absent in GA.
Non-necrobiotic sarcoidal or tuberculoid type of GA: Rare variant.
Dermal mucin and eosinophils help in distinguishing this lesion from sarcoidosis.
Perforating GA: Epidermal perforation connected to the underlying necrobiotic granuloma.