Is biologic therapy the future of granuloma annulare treatment?

Abstract

Granuloma annulare (GA) is a benign inflammatory skin disease that presents with erythematous papules and annular plaques. The pathogenesis of GA remains unknown and may potentially involve type 1 T helper cell (Th1)-mediated delayedtype hypersensitivity reaction. GA is associated with many conditions such as malignancy, trauma, thyroid disease, diabetes mellitus, and viral infection. The role of biological treatment is under investigation. In this article, we present a case of GA development following systemic treatment of psoriatic arthritis in a 59-year-old patient; golimumab therapy resulted in the successful treatment of both psoriatic arthritis and GA. This is the first case report describing GA therapy using golimumab.

Immunohistochemical Features of MMP-9 and pSTAT1 in Granuloma Annulare and Sarcoidosis: A Comparative Study of 62 Cases

“…Granuloma annulare is an inflammatory skin disease. This condition is not considered to be a unique disease but rather a reaction to a variety of factors such as malignancy, trauma, thyroid disease, diabetes mellitus, and viral infection [ 22 ]. The pathogenesis of GA may involve a Th1 cell-mediated delayed-type hypersensitivity reaction to an unknown antigen [ 22 , 23 ].…”

“…This condition is not considered to be a unique disease but rather a reaction to a variety of factors such as malignancy, trauma, thyroid disease, diabetes mellitus, and viral infection [ 22 ]. The pathogenesis of GA may involve a Th1 cell-mediated delayed-type hypersensitivity reaction to an unknown antigen [ 22 , 23 ]. T cells, macrophages, and fibroblasts are found in the tissue microenvironment of GA skin lesions [ 15 ].…”

Concomitant Subtypes of Granuloma Annulare in a 66-Year-Old Female: A Case Report

“…Phototherapy (specifically PUVA (psoralen and UVA) and PDT (photodynamic therapy)), on the other hand, has also been considered an optimal alternative with good results, but due to their monetary costs and higher risk of squamous cell carcinoma in long treatments, it is left as a second-line treatment, as well as UVB/nbUVB/excimer laser [ 2 , 8 , 10 ]. The new treatment option studies have been inclined in biologic therapies using adalimumab, etanercept, infliximab, and dupilumab with interesting and promising results, though further research is needed, especially when cases of GA caused by some of these molecules have been reported [ 2 , 11 , 12 ].…”

Molecularly Targeted Therapies for Inflammatory Cutaneous Granulomatous Disorders: A Review of the Evidence and Implications for Understanding Disease Pathogenesis

“…Four of five patients treated with infliximab (80%) experienced clearance of GA, whereas the fifth experienced a near-complete response ( Bürgler et al., 2019 ; Chen et al., 2019 ; Fanning et al., 2010 ). One patient treated with golimumab experienced clearance after 3 months of therapy ( Dopytalska et al., 2022 ).…”