Treatment of Granuloma Annulare with the 585 nm Pulsed Dye Laser

Abstract

BACKGROUND. Granuloma annulare is a chronic asymptomatic dermatosis that is typically manifested by annular papules arising on the dorsa of the hands, feet, elbows, and knees. Multiple treatment modalities have been used with variable efficacy, but no known cure exists. Obtaining long-term resolution of involved areas is often a therapeutic challenge. OBJECTIVE. We report the results of treatment of a patient with localized erythematous granuloma annulare with a 585 nm flashlamp-pumped pulsed dye laser. METHODS.A single granuloma annulare plaque present on the left wrist for 3 years was treated on three occasions with a 585 nm flashlamp-pumped pulsed dye laser initially and repeated at months 5 and 13. RESULTS. After initial pulsed dye laser treatment, significant flattening and reduction of erythema were evident within the treated area. After a second treatment at month 5 and a third treatment at month 13, further improvement was evident, and long-term remission was achieved.CONCLUSION. Localized granuloma annulare may be difficult to manage, presenting a therapeutic challenge. Thorough understanding of available treatment options, their relative efficacies, and risks of complication can facilitate successful management of this chronic disease. Pulsed dye laser therapy may be an effective and relatively safe treatment option for erythematous granuloma annulare, although prospective studies in additional patients would be desirable. Improvement of the condition in a single patient does not imply that others might improve, and variability in response is more likely.

Treatment of granuloma annulare with the 595‐nm pulsed dye laser, a multicentre retrospective study with long‐term follow‐up

“…17 The only two cases of GA treated with PDL that we have found in the literature reported encouraging success. 7,8 However, our study showed only few cases of marked improvement. Those disappointing results have to be modulated depending on the type of GA, as the response in generalized GA was clearly poorer than in localized GA, and all lesions that recurred were generalized forms of GA.…”

“…6 Two other cases (one child and one adult) improved after pulsed dye laser (PDL) treatment suggesting the interest of this technique. 7,8 The objective of this study was thus to evaluate the efficacy and tolerance of PDL in treating GA.…”

Treatment of Granuloma Annulare with the 595 nm Pulsed Dye Laser in a Pediatric Patient

“…Treatment options are narrowed when treating GA in a pediatric patient as to specifically avoid systemic toxicity. For this reason, we proposed that the 595 pulsed dye laser (PDL) would be an effective treatment option for erythematous GA with low morbidity based on a case report by Sniezek et al (6).…”

Granuloma Annulare Successfully Treated Using Fractional Photothermolysis with a 1,550-nm Erbium-Doped Yttrium Aluminum Garnet Fractionated Laser

“…Multiple case reports and series have noted successful outcomes with various forms of laser treatments. Treatment with 585-and 595-nm pulsed dye laser (PDL) therapy was found to be useful with GA. 17,18 Although the effectiveness of these lasers in vascular lesions is well known, their mechanism of action in GA is unclear. Recent advancements in laser technology have increased the armamentarium available in managing GA.…”