Clinicopathologic Analysis of Granuloma Annulare With Insights Into Its Incidence and Demographics in the United Arab Emirates From 2016 to 2023.

Abstract

Granuloma annulare (GA) is a benign, often chronic dermatologic condition with varying clinical presentations and has been associated in the literature with a notable psychosocial burden, particularly in generalized cases. This retrospective cross-sectional study analyzed the epidemiological and clinicopathological features of GA and its variants in the United Arab Emirates (UAE) from 2016 to 2023. A total of 171 histopathologically confirmed GA cases were included, collected from a single dermatopathology center. The incidence of GA diagnoses showed temporal variation, peaking in 2020 at 0.67% (n = 27) and declining significantly to 0.27% (n = 20) by 2023, as confirmed by a two-proportion z-test (z = 3.24, p = 0.001). However, no significant monotonic trend was observed across the full eight-year period (ρ = -0.19, p = 0.65). Localized GA emerged as the predominant subtype (n = 118, 69.0%), with a marked female predominance across the cohort. The mean age of patients was 39.49 ± 13.87 years, and middle-aged adults (36-55 years) constituted the largest age group (n = 82, 48%). A chi-square goodness-of-fit test demonstrated a statistically significant difference in the distribution of GA variants (χ²(3, N = 171) = 186.54, p < 0.001), with interstitial, papular, and deep GA occurring less frequently than expected. Lesions most frequently involved the upper and lower limbs. While age distribution across GA subtypes did not show a statistically significant association (χ²(12, N = 171) = 13.62, p = 0.326), demographic patterns revealed a richly diverse patient population representing over 35 nationalities, with British and Emirati individuals comprising a notable portion. These findings contribute meaningful insight into the epidemiology and clinicopathology of GA in a multicultural setting and offer a foundation for further exploration into immunologic and genetic factors that could drive precision-based treatment strategies.