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    What do annular granulomas on the shin indicate despite using steroids and Methotrexate?

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Posted on Tue, 24 Oct 2017 in Skin Hair and Nails
Question: Hi. so I have had annular granulomas on my shin that keep speading for 5 years and will not go away with
steroids or methotrexate. I have been diagnosed with hypothyroid and RA in the meantime. I was only seen at a rheumatologist because my doctor suspected it was Lupus, it was not. Do you think it could be Lymes?
doctor
Answered by Dr. Lekshmi Rita Venugopal 1 hour later
Brief Answer:
Evaluation of annular granuloma

Detailed Answer:
Hello,
Thank you for trusting HealthcareMagic for your health concern,
Reviewed the attached image,

The causes of annular granuloma include diabetes, thyroid problems, sun exposure, insect bite, and infections.

Lyne disease is definitely a possibility. Presence of Borrelia (bacteria causing Lyme disease) can be confirmed by doing the FFM (Focus floating microscopy) testing and PCR analysis of the tissue. Once confirmed antibiotics need to be initiated.

I also recommend getting your sugar levels checked to rule out diabetes. Adequately treat hypothyroidism. Take thyroid medications as prescribed.

If steroid creams are not helping, a steroid injection into the annular granuloma can be tried.

Hope this answers your questions
Please feel free to address further questions here

Regards
Dr.Lekshmi

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Lekshmi Rita Venugopal 1 hour later
But does Borrelia live as granuloma she on your skin for more than 3 years?
doctor
Answered by Dr. Lekshmi Rita Venugopal 1 hour later
Brief Answer:
Follow up answer

Detailed Answer:
Hello again,

Yes, it is possible for the Borrelia infection to persist and cause Granuloma Annulare for many years.

Regards
Dr.Lekshmi
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Lekshmi Rita Venugopal 37 minutes later
What is difference between just borrelia and just lymes?
doctor
Answered by Dr. Lekshmi Rita Venugopal 5 minutes later
Brief Answer:
Follow up answer

Detailed Answer:
Hello again,

Lyne is the side as caused by infection with the bacteria 'Borrelia Burgdorgferi'.
Borrelia is the name of the bacteria and lyme is the name of the disease caused by it.

Regards
Dr.Lekshmi
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Lekshmi Rita Venugopal

General & Family Physician

Practicing since :2012

Answered : 3186 Questions

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