Generalized granuloma annulare

Generalized granuloma annulare is a skin condition of unknown cause, tending to affect women in the fifth and sixth decades, presenting as a diffuse but symmetrical, papular or annular eruption of more than ten skin lesions, and often hundreds.

Signs and symptoms
Generalized granuloma annulare is a chronic granulomatous dermatosis that typically affects young adults' distal extremities and manifests as annular grouped papules. On the trunk and extremities, numerous flesh-colored papules arranged in an annular pattern are the hallmark of generalized granuloma annulare. These lesions are frequently itchy, in contrast to the traditional presentation.

Causes
A variety of factors, such as infection, sun exposure, medication use, and trauma, appear to play a role in the development of the disease.

Diagnosis
It has been observed that certain laboratory abnormalities exist, such as hyperlipidemia, hypergammaglobulinemia, and the presence of circulating antinuclear antibodies. Histopathologic analysis may show lymphohistiocytic granuloma-related alterations primarily in the papillary and mid dermis. Palisaded or interstitial patterns, or a combination of the two, may be seen in inflammatory infiltrates.

Treatment
Generalized granuloma annulare is mostly treated with phototherapy as opposed to oral steroids, however treatment efficacy is constrained by a high rate of recurrence after stopping treatment.

Epidemiology
Generalized granuloma annulare accounts for up to 15% of granuloma annulare cases.