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Granuloma annulare - External and Internal Eye
See also in: Overview
Other Resources UpToDate PubMed

Granuloma annulare - External and Internal Eye

See also in: Overview
Contributors: Lauren Strazzula MD, Vivian Wong MD, PhD, Susan Burgin MD, Belinda Tan MD, PhD, Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed


Granuloma annulare (GA) is a benign inflammatory disorder of unknown etiology that targets the dermis or subcutaneous tissues. It manifests as small dermal papules that may coalesce or expand to form annular plaques. The disorder is usually localized, but other clinical variants exist, including a generalized form. The disease is seen more frequently in women and commonly presents within the first 3 decades of life. GA usually resolves spontaneously with no adverse sequelae.

Some reports in the literature have suggested that GA is associated with certain triggers or systemic diseases, such as thyroid disease, diabetes mellitus, dyslipidemia, malignancy, and infections; however, this is now considered controversial.

Rare cases of GA presenting around the eye have been reported; it usually presents in a nodular (subcutaneous) form and is more often seen in younger patients. There have been rare case reports of patients with GA developing uveitis; however, whether this is associated is still unknown.


L92.0 – Granuloma annulare

65508009 – Granuloma annulare

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

When only eyelid lesions are present, consider alternative diagnoses of:
  • Sarcoidosis
  • Hordeolum and chalazion
  • Arthropod bite or sting
  • Discoid lupus erythematosus
  • Rheumatoid nodule
When seen on the non-ocular areas, GA is often mistaken for Tinea faciei (ringworm). The presence of scale in dermatophyte infection should allow the distinction. Other non-ocular involvement differential diagnoses are:
  • Erythema annulare centrifugum
  • Lichen planus
  • Leprosy
  • Erythema elevatum diutinum
  • Actinic granuloma
  • Necrobiosis lipoidica
  • Reactive perforating collagenosis
  • Elastosis perforans serpiginosa
  • Erythema migrans (Lyme disease)

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Updated:09/08/2016
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Patient Information for Granuloma annulare - External and Internal Eye
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Granuloma annulare - External and Internal Eye
See also in: Overview
A medical illustration showing key findings of Granuloma annulare : Ankle, Dorsum of foot, Dorsum of hand, Fingers
Clinical image of Granuloma annulare - imageId=25856. Click to open in gallery.  caption: 'Annular, orange-red, smooth plaque on the dorsal hand.'
Annular, orange-red, smooth plaque on the dorsal hand.
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