Granuloma annulare has been hypothesized to be associated with tuberculosis, insect bites, trauma, sun exposure, thyroiditis, vaccinations, and viral infections, including HIV, Epstein-Barr virus, hepatitis B virus, hepatitis C virus, and
herpes zoster virus. However medications like ACE inhibitors which are used as antihypertensives can often trigger granuloma annulare. Lisiniopril is an ACE inhibitor.