Long lasting interstitial generalized granuloma annulare on sun‐exposed areas

Andreu-Barasoain, Marta; Fuente, Enrique Gómez de la; Pinedo, Fernando; Villegas, Reyes Gamo; Sánchez-Gilo, A.; López-Estebaranz, J.L.

doi:10.1111/j.1600-0781.2012.00664.x

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…The main side effects associated with FAEs include gastrointestinal, flushing, reversible elevation of transaminases, lymphocytopenia, and eosinophilia. 125 Antimalarials are often used in the treatment of generalized GA. Chloroquine (250 mg daily) was successfully used in a patient with photodistributed GA. 126 Hydroxychloroquine has been used in the treatment of generalized GA. 127,128 Cannistraci and colleagues 127 treated 9 patients with generalized GA with 4 months of hydroxychloroquine (9 mg/kg/d for 2 months; 6 mg/kg/d for month 3; and 2 mg/kg/d for month 4). In this series of patients, complete remission was seen in all patients within 6 to 7 weeks of initiation of therapy.…”

Section: Evaluation and Managementmentioning

confidence: 99%

“…Immunosuppression with methotrexate, cyclosporine, and TNF-a inhibitors can be considered in patients with severe disease that has been recalcitrant to other therapies. 28,[87][88][89][90][91][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][114][115][116][117][118][119][120][121][122][123][124]126,127,129,130,[132][133][134][140][141][142][144][145][146][147][148]150,…”

Section: Evaluation and Managementmentioning

confidence: 99%

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Granuloma Annulare

Keimig

2015

Dermatologic Clinics

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Granuloma annulare (GA) is a noninfectious granulomatous skin condition that can present with a variety of cutaneous morphologies. It is characterized by collagen degeneration, mucin deposition, and palisaded or interstitial histiocytes. Although the mechanism underlying development of GA is unknown, studies point to a cell-mediated hypersensitivity reaction to an as-yet undetermined antigen. Systemic associations with diabetes, thyroid disorders, lipid abnormalities, malignancy, and infection are described in atypical GA. Treatment is divided into localized skin-directed therapies and systemic immunomodulatory or immunosuppressive therapies. The selected treatment modality should be based on disease severity, comorbid conditions, consideration of potential side effects, and patient preference.

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Section: Evaluation and Managementmentioning

confidence: 99%

Section: Evaluation and Managementmentioning

confidence: 99%

Granuloma Annulare

Keimig

2015

Dermatologic Clinics

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“…Possible relationships have been reported between GA and diabetes mellitus, thyroid diseases, lipid metabolic disorders, lymphoma and other malignant diseases, insect bites, acquired immunodeficiency syndrome and other viral infections . The familial occurrence of GA appears to be rare, and only a few cases have been reported …”

Section: Introductionmentioning

confidence: 99%

“…1,3,8,9 Possible relationships have been reported between GA and diabetes mellitus, thyroid diseases, lipid metabolic disorders, lymphoma and other malignant diseases, insect bites, acquired immunodeficiency syndrome and other viral infections. 10 The familial occurrence of GA appears to be rare, and only a few cases have been reported. 11,12 Localized GA is likely to resolve spontaneously within months or a few years, while GGA may persist for years 13 and responds poorly to treatment.…”

Section: Introductionmentioning

confidence: 99%

Treatment of generalized granuloma annulare – a systematic review

Lukács

Schliemann

Elsner

2015

Acad Dermatol Venereol

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Granuloma annulare (GA) is a benign inflammatory skin disease. Localized GA is likely to resolve spontaneously, while generalized GA (GGA) is rare and may persist for decades. GGA usually is resistant to a variety of therapeutic modalities and takes a chronic course. The objective of this study was to summarize all reported treatments of generalized granuloma annulare. This is a systematic review based on MEDLINE, Embase and Cochrane Central Register search of articles in English and German and a manual search, between 1980 and 2013, to summarize the treatment of generalized granuloma annulare. Most medical literature on treatment of GGA is limited to individual case reports and small series of patients treated without a control group. Randomized controlled clinical studies are missing. Multiple treatment modalities for GGA were reported including topical and systemic steroids, PUVA, isotretinoin, dapsone, pentoxifylline, hydroxychloroquine, cyclosporine, IFN-γ, potassium iodide, nicotinamide, niacinamide, salicylic acid, dipyridamole, PDT, fumaric acid ester, etanercept, infliximab, adalimumab. While there are numerous case reports of successful treatments in the literature including surgical, medical and phototherapy options, well-designed, randomized, controlled clinical trials are required for an evidence-based treatment of GGA.

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Etiology, Diagnosis, and Therapeutic Management of Granuloma Annulare: An Update

2013

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Granuloma annulare (GA) is a common cutaneous disorder classically presenting as annular groups of skin-colored to erythematous papules without epidermal change localized to the dorsal hands and/or feet. In addition to the localized form, there are variants including generalized (including generalized annular GA, disseminated papular GA, and atypical generalized GA), subcutaneous, and perforating GA, providing for a wide spectrum of clinical lesions. The etiology of GA remains unknown and several systemic associations have been proposed but not proven, including diabetes mellitus, malignancy, thyroid disease, and dyslipidemia. The diagnosis of GA relies on clinicopathological correlation, with a skin biopsy confirming the histological features of the disease, including palisading granulomas, collagen degeneration, mucin, and a lymphohistiocytic infiltrate. Localized GA is often asymptomatic and self-limited within 2 years; however, the patient may desire treatment for cosmetic reasons, with topical and intralesional corticosteroids as the mainstays of therapy. When GA is generalized, disseminated, or atypical, a more thorough medical workup for underlying diseases may be considered depending on the physical examination, a thorough review of systems, comorbidities, and clinical suspicion. Treatment is often challenging for generalized GA, especially because of its recalcitrant nature and a lack of evidence-based therapy. Over 30 different treatments have been described for GA with variable results; however, the majority of these have been single case reports, small case series, or retrospective studies. Reported treatments for GA include topical, intralesional, intramuscular, and oral medications (steroidal vs. non-steroidal); biologic agents; surgical interventions; phototherapy; and laser treatments. When selecting a systemic therapy for a patient with GA, multiple variables must be considered, such as baseline blood evaluations, comorbidities, drug interactions, compliance, adverse effect profiles, prior treatments, and reproductive status. This evidence-based review will focus on the advances made in the twenty-first century regarding the etiology, diagnosis, and therapeutic management of GA.

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Long lasting interstitial generalized granuloma annulare on sun‐exposed areas

Cited by 8 publications

References 7 publications

Granuloma Annulare

Granuloma Annulare

Treatment of generalized granuloma annulare – a systematic review

Etiology, Diagnosis, and Therapeutic Management of Granuloma Annulare: An Update

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