Over time, the papules and patches of granuloma may coalesce in to large confluent areas.

The ankle is a common site for granuloma annulare, as are the dorsal hands and fingers. Although rare, granuloma annulare can be generalized.

Granuloma annulare lesions are pink to flesh-colored annular patches or plaques, with an elevated border and central clearing. It is often misdiagnosed as ringworm.