Is Granuloma Annulare an Autoimmune Disease?
I’m surprised by how many people ask if Granuloma Annulare (GA) is an autoimmune disease. I mean, I get why it’s confusing. Some doctors say it’s benign & nothing to worry about. Next minute your dermatologist is telling you that it’s autoimmune & that you need a steroid.
It’s hard to put a label on something that they don’t know how to fix. Or what even causes it.
Here’s 4 reasons why we think GA is autoimmune & why it can’t be ignored:
1. Chronic Inflammation
Granuloma annulare is described as a chronic inflammatory skin condition. Chronic inflammation underlies every single disease including autoimmune disease. Autoimmunity is never an overnight process, the body doesn’t just wake up one day & decide to attack itself. There are clues in your past that have lead you to this diagnosis today. The answer will be there. The mystery is in your history! Instead of shutting down inflammation with steroids, we should be asking better questions:
Where is the inflammation coming from?
Why are the immune cells in your skin on high alert?
No matter what the doctor tells you, having a rash on your skin is NOT normal.
2. When you have one autoimmune disease, expect there might be more:
Granuloma Annulare is associated with other autoimmune diseases, such as hypothyroidism, lupus and diabetes mellitus. This tells us it’s likely a systemic problem and not just a skin condition. Granuloma Annulare is the symptom on the skin – it’s telling you where the problem is presenting, not where it’s coming from.
3. If it’s autoimmune, but just on the skin, it’s not as bad…right?
WRONG
I’m not sure where this train of thought came from. Autoimmune disease is autoimmune disease. When the body is having a heightened inflammatory response to “self”, it ain’t good. The skin is also your largest organ of the body. Having the largest organ of your body in a chronically inflamed state isn’t ideal. We don’t need a blood test see if inflammation is present, it’s literally written all over your skin. For some reason, we ignore the most obvious signs screaming at us that something is wrong, just because it’s on the skin!
4. The dermis:
Granuloma annulare is found in a layer of the skin called the dermis. This layer is full of cells called fibroblasts, which make collagen to give our skin strength. However, this is not the only thing they do. Fibroblasts are also immune cells. They’re recruited by the immune system when we need them for wound repair or infection control, amongst other things. A little inflammation is a good thing. Excessive, chronic inflammation is not.
We need to start recognising that this skin condition is an autoimmune disease process.
We also need to stop telling people to ignore it for 2 years and hope that it will go away. It’s time to ask better questions.
Why is your body attacking itself? Why is your immune system in overdrive? What type of immune response do you have (Th1, Th2, Th17)? What is your immune system trying to protect you from?
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