Granuloma annulare (GA) is an asymptomatic condition. It begins as flat-topped to pinpoint firm red papules, 1 to 3 mm in diameter, which gradually enlarge to create a coin-like appearance (Fig. 46-1). The lesions are usually on the dorsal aspects of the hands and feet but may be found on the face, buttocks, ankles, wrists, and elbows. Sometimes, GA persists for several years and can involve most of the body—disseminated GA. Other forms of GA are rare: a plaque type that is flat and infiltrated, resembling necrobiosis lipoidica; an erythematous type that has red papules as the predominant morphology; a subcutaneous type that presents as subcutaneous nodules; and the perforans type, which ulcerates.