Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (713 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Benign granulomatous disease of unknown etiology characterized by a ring of localized or disseminated papules or nodules on the skin and palisading histiocytes surrounding necrobiotic tissue resulting from altered collagen structures.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Where it fits in the MeSH classification
- Broader topics
- Necrobiotic Disorders; Granuloma
Research landscape
PubMed indexes 1,070 records tagged with the MeSH heading “Granuloma Annulare” (counts retrieved 2026-11-04). 181 of them (16.9%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 329 records.
Reviews account for 136 records (12.7%) and meta-analyses for 1. Randomized controlled trials number 1 (0.1%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 269 |
| 2000-2009 | 291 |
| 2010-2019 | 329 |
| 2020 onward | 181 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 136 | 12.7% |
| Meta-analyses | 1 | 0.1% |
| Randomized controlled trials | 1 | 0.1% |
Method: PubMed query "Granuloma Annulare"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in bones, joints, muscles and skin
Joint, bone, muscle and skin conditions are often judged by pain scores, function questionnaires, imaging or photographs, and symptoms can fluctuate, so placebo response and natural improvement matter. Imaging changes are common in people without symptoms. Nothing on this page is advice about treatment. Check how outcomes were measured, whether the comparison group received a placebo or usual care, and how long the benefit lasted.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Dimethyl Fumarate Used as an Effective Treatment for Granuloma Annulare Disseminatum: An Immunohistochemical Case Study | 2023 | Research article Design not recorded in structured metadata | 2 | cc by PMID 37686161 · DOI · PMC10487489 |
| Granulomatous Dermatitis and Systemic Disease: An Association to Consider | 2020 | Research article Design not recorded in structured metadata | 2 | cc by PMID 33062676 · DOI · PMC7545450 |
| Immunohistochemical Features of MMP-9 and pSTAT1 in Granuloma Annulare and Sarcoidosis: A Comparative Study of 62 Cases | 2023 | Research article Design not recorded in structured metadata | 2 | cc by PMID 36959923 · DOI · PMC10030222 |
| Management Strategies for Generalised Granuloma Annulare: A Systematic Review of Current and Emerging Therapies | 2025 | Systematic review Design not recorded in structured metadata | 1 | cc by PMID 40586485 · DOI · PMC12418146 |
Dimethyl Fumarate Used as an Effective Treatment for Granuloma Annulare Disseminatum: An Immunohistochemical Case Study [1]
Abstract reading summary — source excerpts
- Opening excerpt
- This investigation demonstrates the use of dimethyl fumarate (DMF) for the treatment of disseminated granuloma annulare (GAD), a rare and chronic inflammatory skin disease.
- Closing excerpt
- These findings support the use of DMF as a promising treatment option for this rare skin condition.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (103 words)
This investigation demonstrates the use of dimethyl fumarate (DMF) for the treatment of disseminated granuloma annulare (GAD), a rare and chronic inflammatory skin disease. In this case, progressive GAD was treated with DMF, resulting in significant improvement of skin lesions within 5 weeks and complete healing within 7 months. Clinical response was associated with a reduction in inflammatory cells, including both T cell subsets (CD4+ > CD8+), CD183+/CXCR3+ cells, Langerhans cells (CD1a+), myeloid DCs, M1- and M2-like macrophages and the activation marker HLA-DR in immunohistochemical analysis. These findings support the use of DMF as a promising treatment option for this rare skin condition.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37686161 · DOI · PMC10487489
Granulomatous Dermatitis and Systemic Disease: An Association to Consider [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Granuloma annulare (GA) and interstitial granulomatous dermatitis (IGD) are granulomatous dermatoses with variable clinical appearances.
- Closing excerpt
- Sjogren syndrome may be associated to GA also in Caucasians.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (162 words)
Granuloma annulare (GA) and interstitial granulomatous dermatitis (IGD) are granulomatous dermatoses with variable clinical appearances. GA is associated with diabetes mellitus, metabolic syndrome, chronic infections, and malignancies, while two Japanese reports described unusual cases of interstitial-type GA in setting of Sjogren syndrome. IGD was associated with rheumatoid arthritis, systemic lupus erythematosus, and autoantibodies. We report a case series of six patients with GA or IGD. Half of the patients were diagnosed with Sjogren syndrome, while all of them presented ANA positivity and the majority reported arthralgia. In many cases, GA showed interstitial-type histology, arising challenges in differential diagnosis with IGD. The overlap of clinical and histological features of GA and IGD can be explained considering them as a broad disease spectrum, including also the other forms of reactive granulomatous dermatitis. These conditions should be considered as an indicator of possible systemic disorders or other immunological dyscrasias, for which patients must be screened. Sjogren syndrome may be associated to GA also in Caucasians.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33062676 · DOI · PMC7545450
Immunohistochemical Features of MMP-9 and pSTAT1 in Granuloma Annulare and Sarcoidosis: A Comparative Study of 62 Cases [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundGranuloma annulare (GA) and sarcoidosis are granulomatous inflammatory diseases that share similarities.
- Closing excerpt
- ConclusionThese results indicate that MMP-9 and pSTAT1 might exert roles in granulomatous inflammation in different modes, and the presence of more robust MMP-9 staining in EFs appears to be more suggestive of GA.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (199 words)
BackgroundGranuloma annulare (GA) and sarcoidosis are granulomatous inflammatory diseases that share similarities.ObjectiveTo identify the histological and immunohistochemical (IHC) features of GA and sarcoidosis.MethodsA retrospective review of 36 patients with GA and 26 with sarcoidosis was performed. Results from hematoxylin and eosin (H&E) staining and IHC staining of MMP-9 and pSTAT1 within the skin lesions of GA and sarcoidosis were analyzed, and random forest was applied for developing a predictive model.ResultsSignificantly greater expressions of MMP-9 (especially in elastic fibers, EFs, P P = 0.0003) were observed in lesion samples of GA versus sarcoidosis patients. In GA patients, MMP-9 was significantly upregulated in the interstitial type (P = 0.0222), while staining of pSTAT1 was positively correlated with the area of mucinous collagen in palisading GA (R = 0.5356, P = 0.0484). In sarcoidosis patients, MMP-9 (R = -0.7127, P = 0.0009) and pSTAT1 (R = -0.5604, P = 0.0067) were found to show stronger expressions in lesions with less lymphocyte infiltration. The predictive model demonstrated an AUC of 0.9675.ConclusionThese results indicate that MMP-9 and pSTAT1 might exert roles in granulomatous inflammation in different modes, and the presence of more robust MMP-9 staining in EFs appears to be more suggestive of GA.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36959923 · DOI · PMC10030222
Management Strategies for Generalised Granuloma Annulare: A Systematic Review of Current and Emerging Therapies [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Generalised Granuloma Annulare (GGA) is a chronic inflammatory skin disorder with no standard treatment.
- Closing excerpt
- Tailored, multimodal strategies may improve outcomes, though further trials are needed to standardise guidelines.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (249 words)
Generalised Granuloma Annulare (GGA) is a chronic inflammatory skin disorder with no standard treatment. Since the last review in 2013, new treatments and varied responses have highlighted the need for an updated synthesis to guide clinical decisions. This systematic review aimed to evaluate the epidemiology, comorbidities and treatment outcomes in patients with GGA, synthesising evidence from published studies to provide insights into both conventional and emerging therapeutic strategies. A systematic literature search was conducted in CENTRAL, Embase and PubMed, following PRISMA guidelines. Studies published in English, French or Spanish up to January 15, 2024, were included. Data extraction focused on patient demographics, comorbidities, treatment regimens and therapeutic outcomes. A total of 689 patients were included. The mean age of patients was 52.8 years, with a female predominance (72.6%). Based on this systematic review, we propose a stepwise approach: first-line treatment includes hydroxychloroquine and phototherapy (PUVA > UVA1 > nb-UVB). Oral corticosteroids along with high-potency topical steroids or calcineurin inhibitors may be used in extensive or rapidly progressive disease or as bridging therapy pending slower-acting agents. Sulfones are second-line, with oral retinoids (e.g., isotretinoin) as alternatives if contraindicated. For refractory cases, off-label anti-TNF-α agents or JAK inhibitors are recommended, with methotrexate or cyclosporine as valid alternatives. This largest systematic review of GGA treatments offers an evidence-based clinical framework. While steroids and phototherapy remain standard, emerging options like JAK inhibitors and biologics show promise for refractory cases. Tailored, multimodal strategies may improve outcomes, though further trials are needed to standardise guidelines.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40586485 · DOI · PMC12418146
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Granuloma annulare: Clinical and histologic variants, epidemiology, and genetics [5]
- Research article Granuloma annulare: Pathogenesis, disease associations and triggers, and therapeutic options [6]
- Research article Granuloma Annulare: An Updated Review of Epidemiology, Pathogenesis, and Treatment Options [7]
- Research article Etiology, diagnosis, and therapeutic management of granuloma annulare: an update [8]
- Research article Dimethyl fumarate - only an anti-psoriatic medication? [9]
- Research article Granuloma annulare [10]
References
- Gabutti M, Heidemeyer K, Seyed Jafari SM, Bossart S, Hunger RE, Feldmeyer L, et al.. Dimethyl Fumarate Used as an Effective Treatment for Granuloma Annulare Disseminatum: An Immunohistochemical Case Study. . 2023. PMID 37686161 · DOI · PMC10487489
- Corrà A, Quintarelli L, Verdelli A, Portelli F, Massi D, Caproni M. Granulomatous Dermatitis and Systemic Disease: An Association to Consider. . 2020. PMID 33062676 · DOI · PMC7545450
- Wu Z, Li L, Qu H, Qi RQ, Niu J. Immunohistochemical Features of MMP-9 and pSTAT1 in Granuloma Annulare and Sarcoidosis: A Comparative Study of 62 Cases. . 2023. PMID 36959923 · DOI · PMC10030222
- Bettolini L, Maione V, Carugno A, Stabile G, Podo Brunetti A, Fratton Z, et al.. Management Strategies for Generalised Granuloma Annulare: A Systematic Review of Current and Emerging Therapies. . 2025. PMID 40586485 · DOI · PMC12418146
- Piette EW, Rosenbach M. Granuloma annulare: Clinical and histologic variants, epidemiology, and genetics. J Am Acad Dermatol. 2016. PMID 27543209 · DOI
- Piette EW, Rosenbach M. Granuloma annulare: Pathogenesis, disease associations and triggers, and therapeutic options. J Am Acad Dermatol. 2016. PMID 27543210 · DOI
- Joshi TP, Duvic M. Granuloma Annulare: An Updated Review of Epidemiology, Pathogenesis, and Treatment Options. Am J Clin Dermatol. 2022. PMID 34495491 · DOI · PMC8423598
- Thornsberry LA, English JC. Etiology, diagnosis, and therapeutic management of granuloma annulare: an update. Am J Clin Dermatol. 2013. PMID 23696233 · DOI
- Meissner M, Valesky EM, Kippenberger S, Kaufmann R. Dimethyl fumarate - only an anti-psoriatic medication?. J Dtsch Dermatol Ges. 2012. PMID 22897153 · DOI
- Smith MD, Downie JB, DiCostanzo D. Granuloma annulare. Int J Dermatol. 1997. PMID 9199977 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.