Ring-shaped granuloma

The chronic disease of skin which is characterized by emergence of the towering dense small knots creating a ring with slightly sinking down or normal skin in the center is called a ring-shaped granuloma.

The disease in most cases proceeds asymptomatically and does not demand special treatment, however for acceleration of healing of small knots the doctor can appoint corticosteroid cream or hypodermic introduction of corticosteroids. According to statistical data, the ring-shaped granuloma occurs at 0,4% of patients with dermatological diseases.

The origin of a granuloma remains to the unknown, however pathologies of immune system against the background of which allergic reactions of the slowed-down type develop are assumed and cellular immunity is broken. The factors contributing to a ring-shaped granuloma are:

• Sarcoidosis and tuberculosis;
• Conducting tuberkulinovy tests;
• Genetic predisposition;
• Autoimmune thyroiditis;
• Rheumatism and vasculitis;
• Long reception of vitamin D;
• Skin injuries, sunblisters and stings of insects;
• Diabetes mellitus.

Allocate the following forms of a ring-shaped granuloma:

• Disseminated;
• Hypodermic;
• Perforating;
• Localized.

In medical practice cases when the ring-shaped granuloma developed on site hems and tattoos, after shingles and warts often meet.

Symptoms of a ring-shaped granuloma

The main symptom of a ring-shaped granuloma is emergence on the skin of the patient of small knots of yellowish color, or a shade surrounding the struck place of skin. These small knots can form one or several rings, often appear on feet, brushes, hands and legs of adults and children. The ring-shaped granuloma usually does not cause an itch or pain in the place of emergence.

Ring-shaped granuloma at children

The form of a granuloma which is the most extended among children is localized, it meets in 90% of cases. On extensor surfaces of brushes, hands, feet and shins, is more rare in periorbital area, one or several centers with dense thermal papules appear. Color of educations usually matches tone of surrounding skin, or a little reddish, papules in the form of an arch or a ring of 2-5 cm and more are located, the central site of the center and epidermis usually remain not struck.

The local ring-shaped granuloma at children on the periphery extends, partially recuring or being resolved on the same place. In medical practice cases when children had rings enclosed one in another, reminding a mnogoformny exudative erythema are registered.

The hypodermic form of a ring-shaped granuloma occurs only at children under 6 years, it has an appearance single or the multiple deep, clinically not expressed, hypodermic or thermal small knots on elbows, a periorbital zone, forearms, shins, fingers, the back of brushes and on a pilar part of the head. Feature of this type of a granuloma is that the nodes which are formed on a pilar part of the head in all cases are densely connected to a periosteum while nodes on extremities mobile, and are only in rare instances connected with fastion.

The disseminated ring-shaped granuloma occurs at children extremely seldom, generally from it adults at the age of 50 years suffer and are more senior. Displays of a disease are widespread on all body, and also trunks, papules of a violet shade or skin color are more often on distal sites of extremities. Tendency to a koltsevidnost at such skin educations is absent, polylithism of rashes is noted.

The perforating ring-shaped granuloma occurs generally at children and adults aged up to 30 years. On brushes or fingers of patients there are papules with traffic jams on the center which allocate zhelatinopodobny contents then the centers and crusts with umbilicate impression in the center are formed. These educations develop in large plaques, with atrophic hyper over time - or the hypopigmented hems.

Diagnosis of a ring-shaped granuloma

At emergence of small knots the patient needs to ask for the help the dermatologist or the dermatovenerologist who on a clinical picture will be able to make the exact diagnosis. Only in the most doubtful cases at the patient skin in the place struck with a granuloma can take sample.

Treatment of a ring-shaped granuloma

Usually the disease does not demand special treatment and passes by itself. For more bystry healing of skin the doctor can appoint cream which part corticosteroids, or intradermal administration of corticosteroid drugs are. Important after use of ointment from above to apply an occlusive bandage skin.

Means need to be applied daily for two weeks, then for 2-3 weeks to put time in two days.

Also treatment of a ring-shaped granuloma can be performed by means of superficial scarification, sometimes the biopsy leads to permission of the center.

The phototherapy, Puva-terapiya, Ural federal district, use of retinoids and anti-malarial drugs are included in the list of possible system influences at a granuloma, however any of them is not reliably effective and is not recommended for treatment of children.

It is clinically confirmed that the cryolysis which is used for treatment of a ring-shaped granuloma in cosmetology leads to progressing of a disease and growth of the centers on the periphery.

For treatment of the localized form of a ring-shaped granuloma at children safe means is corticosteroid ointment of the fourth generation Psoriderm which efficiency is confirmed by clinical trials. Thanks to the fact that means is used in a small dose and is applied on the local site of skin, probability of emergence of side effects very low cases with those were not registered.

The ring-shaped granuloma represents high-quality skin nodulation, creating a ring which do not cause pain or an itch. Usually educations take place by itself after a while, however if at the patient manifestations, atypical for a granuloma, are observed, it is necessary to address the dermatologist.