This can keep the patch under control, but it is not unusual for the condition to flare up again at the original site. Treatment involves limited bathing, generous use of alcohol-free moisturizers, and topical steroid creams. Nummular eczema is aggravated by bathing, soaps, and irritants such as wool. Common triggers for development of nummular eczema include medications, dry or damaged skin, bug bites,, and contact with metals like nickel. Itching is variable, and some people also describe a burning-like sensation. The word nummular comes from the Latin word “coin,” and this rash is named so because it is a coin-shaped patch of dry, scaly skin. Nummular eczema is another common skin condition that is often mistaken for ringworm. Often these rings will disappear following a small injection of sterile saline, so if treatment is chosen, I would consider this simple, safe method. Since the ring is usually not bothersome, and usually disappears on its own, I do not routinely recommend treatment. All of these treatments may have side effects, so a thorough discussion with your doctor is needed before pursuing any form of treatment. When lesions are widespread, some physicians recommend treating this condition with steroid injections, freezing treatments (cryotherapy), UV light therapy or even stronger medications. Sometimes localized lesions may respond to topical steroid ointments. In almost half of cases the ring comes back for a while, usually at the original site. Granuloma annulare usually disappears spontaneously within several months of appearing (though it can take years). Most children with granuloma annulare are healthy and don’t go on to develop diabetes or thyroid problems, but these do occur more commonly in people who form these rings than in those who don’t, especially if the rash is widespread. It may, however, be related somehow to diabetes and thyroid disease. I believe it is probably a slow hypersensitivity reaction that some individuals develop to different types of minor trauma.
It is not an infection and is not contagious. No one knows for certain what causes granuloma annulare. The rings vary in size from about 1/4 inch to 2 inches in diameter. The bumps may be red at the beginning, but this disappears as the ring forms. It may occur on any part of the body (though most commonly on the sides or backs of the hands or feet) and is most often localized to one area. Granuloma annulare is a common skin condition with raised, flesh-colored bumps that appear in a ring. Many other skin conditions look similar enough to ringworm (ringworm look-alikes) for the diagnosis to be commonly confused. If the condition does not go away with 4 weeks of treatment, then it was probably not ringworm in the first place. Treat it for at least one week following the clearing of the rash to make sure that all of the fungus is gone. When ringworm is treated with an appropriate antifungal medication, such as Lotrimin, improvement is usually seen within 7 to 10 days.
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