My 15 year old daughter has possible granuloma annulare — she had a biopsy done recently due to several lesions (and her dermatologist believes this is the diagnosis). She was diagnosed with Hashimoto’s Thyroiditis 2 years ago. What is the chance that the granuloma is now related to diabetes? Should she now undergo testing for diabetes — she sees her endocrinologist regularly for her thyroid condition.

That Granuloma Annulare is an autoimmune condition has not really been documented; but it has been seen occasionally in diabetes and in rheumatoid arthritis. The association of granuloma annulare with thyroiditis certainly suggests the possibility of a condition that has come to be recognised as Autoimmune Polyglandular Syndrome Type II, in which there is a grouping of several autoimmune conditions in one subject. Autoimmune diabetes (Type�1A) is one common component and to a much lesser extent so is the celiac syndrome and adrenal insufficiency. If it can be done fairly easily it might be worth testing for appropriate diabetes-related antibodies, if only to reassure or forewarn. A number to get in touch with for more details is 1-800-425-8361 or Quest Diagnostics at 1-949-728-4235.

DOB