What Is Granuloma Annulare?

Small, firm bumps may form a circle or arc on the hands, feet, elbows, knees, or another area. The skin in the centre can look close to normal. The bumps may be skin-coloured, pink, red, purple, or slightly darker than nearby skin. Many people have little or no itch or pain, although irritation can occur. A clinician may recognise the pattern during an examination; a biopsy can be considered when the appearance is unusual or another condition needs to be excluded. Granuloma annulare is not the same as a contagious infection, and it does not spread by touch.

Arrange a skin assessment if a ring-shaped patch is new, enlarging, recurring, or difficult to identify. Take a clear photograph as it changes and mention new medicines, preceding illness, or other symptoms. Treatment is not always needed when the area is mild and stable. If treatment is chosen, options depend on the number, thickness, location, and symptoms of the lesions. Your dermatologist may discuss [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/) or [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/). Avoid scratching and harsh products while the diagnosis is being clarified.

Seek prompt medical advice if the rash is rapidly changing, ulcerated, bleeding, very painful, infected-looking, or associated with fever or feeling unwell. Arrange routine review if it persists, returns repeatedly, involves many areas, or affects your quality of life. A new ring-shaped rash should be examined rather than assumed to be granuloma annulare, because several skin conditions can resemble it.

Could this be granuloma annulare or a different ring-shaped rash? Is a biopsy useful in my case? Would observation be reasonable? Which treatment fits this location and skin type, and what changes should prompt a review?