Granuloma annulare: a review of 41 cases at the National Skin Centre.

INTRODUCTION Granuloma annulare (GA) is a benign, inflammatory skin disorder that has no proven aetiology or widely accepted theory of pathogenesis. We present the results of a local study examining the characteristics of this disorder. MATERIALS AND METHODS This is a retrospective study of 41 patients with granuloma annulare seen at a tertiary dermatological skin hospital in Singapore. The disease was classified based on whether it was localised or generalised. Remission rates and associated diseases were documented. RESULTS The majority (93.9%) of lesions were localised. GA tends to occur within the first three decades of life, and 39.4% of patients were 10 years old and below. There was a slight female preponderance, and no predilection for any particular racial group. Remissions were seen in 67.6% of patients who were followed up for at least 12 months, and remissions only occurred with the localised form of GA. There were 4 cases of disseminated GA and 1 case of perforating GA. There were 6 patients with associated diabetes mellitus, 2 with pulmonary tuberculosis, and 4 patients each with hypercholesterolaemia and a history of atopy. CONCLUSION The characteristics of GA in our local population do not differ significantly from that of overseas studies. While localised forms of GA have a high chance of resolving, the generalised forms of the disease are difficult to treat and do not tend to resolve totally.