Granuloma Annulare in Women: Evaluating the Annular Configuration in the Context of Germline Repair

Abstract

Granuloma annulare (GA) can be seen in both genders and all age groups, but is most commonly seen in women between the ages
of 30-60 years. GA has a striking geometric presentation, with near perfect circles and ovals, a central clear zone and a pinwheel
configured peripheral rim. We designed a retrospective case series comparing biometric and pharmaceutical data in middle aged
women with and without GA to ascertain correlates of the disease. Women with GA were heavier and took more drugs. The use of
statins, proton pump inhibitors and serotonin reuptake inhibitors were seen more commonly among the cases but the differences
were not statistically significant. Hormone Replacement Therapy (HRT) was seen more commonly in the control group. We propose that the key features of granuloma annulare (female predominance, annular morphology with central clearing, and abrupt onset in the later reproductive years) may relate to events in the fertility cycle that change with age and could be altered by medications