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A No-Known Cause Skin Condition

Granuloma Annulare Author Mierlo

Patient writes in with a question concerning round red circles…

"I have a skin disorder called GRANULOMA ANNULA (round red circles slightly raised) Doesn’t hurt or itch, wouldn’t know you have it unless you can see it. The doctors sent me to a skin specialist in the city and they all said they don't know what causes it therefore they can't treat it. The other day I did some more research and it said there's a strong possibility it is caused from wheat gluten. I did an experiment and ate some wheat bread and it got really red. Then I stopped eating the flour products for 4 days and I couldn’t believe what happened, it almost disappeared."

The skin condition known as Granuloma annulare is a painless condition where different areas of the skin have, as you said, round, raised and reddish circular areas. It is usually either localized on the hands and feet or found all over the body.  The doctors you spoke to are correct in saying there is no known “cause”….but there are lots of conditions where we don’t really understand the cause, and these are treated all the time!

What they probably should have said is that we don’t really know how to treat it but many times the localized condition stops on its own. In fact, in a recent review article on Granuloma annulare, it states “Because localized granuloma annulare is self-limited, no treatment other than reassurance may be necessary.”  The spread out form of granuloma annulare is treated with a wide range of agents which have some potentially serious toxic side effects—these include medications such as “dapsone, retinoids, niacinamide, antimalarials, psoralen plus ultraviolet A therapy, fumaric acid esters, tacrolimus, and pimecrolimus1.”

Now, I’m all for minimizing treatment with medications, but it sounds like you didn’t get much in the way of information and reassurance from the doctors. You don’t say whether you have the localized type or if it is all over your body, but you have discovered at least one approach that works well for you!

Granuloma annulare can affect both males and females of all ages, but it is mainly diagnosed in women (about twice as many women as men) before the age of 30. It appears to run in some families and have seasonal peaks in the spring and fall2.  It generally goes away on its own within two months to two years, but can last as long as 10 years….that’s an awful long time to wait!

In naturopathic medicine, we think of the skin as one of the most important organs of the body—its protects us, is a source of Vitamin D….but it also is an organ of excretion—the skin is one of the main ways we get rid of toxins and is one of the important areas where tolerance and sensitivity to foods, beverages, drugs and various toxins show up.  As an example, many drugs have rashes and skin eruptions as a side effect. Your experiment with gluten showed you that your reaction to gluten was a specific skin reaction- Granuloma annulare. I think you have found your own best treatment—and I think you will find living gluten-free has many other benefits besides clearer skin!

References:
1Cyr PR., Diagnosis and management of granuloma annulare.  Am Fam Physician - 15-NOV-2006; 74(10): 1729-34.
2McLelland J, Young S, Marks JM, Lawrence CM. Seasonally recurrent granuloma annulare of the elbows. Clin Exp Dermatol 1991;16:129–30.
Photo: Granuloma annulare on hand - courtesy of Mierlo @ Wikipedia

8 Responses to A No-Known Cause Skin Condition

  1. Karen March 14, 2014 at 8:55 am #

    I have lichen planis!

    • Angie Halten (Admin)
      Angie Halten (Admin) March 14, 2014 at 2:46 pm #

      Have you found any relief by going gluten free?

  2. Karen March 14, 2014 at 7:11 pm #

    I have not started yet. My thyroid doctor said I should start. She said I would probably be good for the lichen planis .

  3. Gloria April 9, 2014 at 8:49 pm #

    I am 52 and I just found out along with gaing 50 pounds this past year that I have an allergey to Gluten, Wheat and Corn.... I need help, The food that is best for me to eat cost to much, it's the healthiest food's! I am on SSI, and no food stamp's and no husband. I live with my mother and off of $720.00 a month for myself! I can't buy the best vege's and fruit's on that! and also have seizure's and cronic pain, so I buy a lot of copay's in medicines.I have a CNA who take's care of me 5 day's a week at 4 hrs. a day and all I get is bacon, egg's, grit's, toast w/ provalone cheese & & coffee. Then I eat 1 lg. bowl of sherbert around lunch time and sometime's I get lucky and for a week I have 2 cases of ensure to splurge on for my dinner because she is gone and I can't use the stove, in case I were to have a seizure when the ensure is gone, I buy hungryman microwaveable meals or other brand for dinner, but breakfast dosen't change or lunch! I need help or a better guide????? do you know of a source??? [email protected] I have tried Garcinia Cambogia 2 times and haven't lost weight, I actually gained 4-6- pnds..each time on 30 day trials each! ???????

    • Angie Halten (Admin)
      Angie Halten (Admin) April 10, 2014 at 11:36 am #

      Hi Gloria, it's important that you find great support from a local doctor. It's impossible (and unethical) for us to diagnose you over the internet but it sounds to me like you could really reach out to people in your community that might know someone that could help. We're pulling for you!

  4. BR April 10, 2014 at 5:07 pm #

    Thank you for posting the granulare annulare note. That's the first time I ever connected my mysterious outbreak in the 90s of granulare annulare covering both my legs, with my (finally in 2010) diagnosis of celiac disease. It's the second kind of skin rash that I have had in connection with CD. The other one was Dermatitis Herpetiformis, which is basically Herpes Simplex I rash, which many celiacs have on their legs. I always had outbreaks of it on my arms. No doctor was ever able to figure that out--one doctor even called in a photographer to document a particular awful outbreak of DH. After I finally realized I had CD and got it diagnosed, and went gluten free, my rashes have essentially gone. Every now and then I get a minor breakout on one of my arms and that is how I know I have been exposed to gluten. It's my "canary in the mine," since my CD symptoms were not overtly "gut symptoms," but I had many of the other (among 300) symptoms of CD. It's no wonder doctors are baffled and only about 1 in 5,000 Celiacs get a firm diagnosis. It's my understanding that about 1 in 132 people actually HAVE CD and most don't know it. Seems like a Complete Celiac Blood Panel should be done on any children who have any mysterious symptoms. I lived a whole lifetime with it and wasn't diagnosed until I was 65!!! Now I'm battling all the secondary issues such as Rheumatoid Arthritis and all the rest of it caused by CD.
    BR

    • Angie Halten (Admin)
      Angie Halten (Admin) April 10, 2014 at 7:48 pm #

      Thank you for sharing your story! I hope that it helps others too

  5. Cynthia July 17, 2014 at 12:10 am #

    Wow. I have had these for years, only they weren't too red, just raised bumps on my hands and I thought they would turn to warts some day. I also have red, rashy looking skin on my upper arms that has been there for around 20 years now. I am 42 and even tried having many different doctors look at it when I was in the military. Not them or VA doctors know what that is. But now that I have been diagnosed with Celiac Disease since January 2014, I now think that this rash, and bumps in the hands and my Gastrointestinal (GERD) problems and bowel and colon problems all began around 20 years ago. I think more Hospitals and Doctors need to look out for and test these things and get more knowledge about GF allergies and symptoms.

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