Granuloma Annulare Questions & Answers

1. Piette EW, Rosenbach M. Granuloma annulare: Pathogenesis, disease associations and triggers, and therapeutic options. J Am Acad Dermatol. 2016 Sep. 75 (3):467-479. [QxMD MEDLINE Link].

2. Piette EW, Rosenbach M. Granuloma annulare: Clinical and histologic variants, epidemiology, and genetics. J Am Acad Dermatol. 2016 Sep. 75 (3):457-465. [QxMD MEDLINE Link].

3. Felner EI, Steinberg JB, Weinberg AG. Subcutaneous granuloma annulare: a review of 47 cases. Pediatrics. 1997 Dec. 100(6):965-7. [QxMD MEDLINE Link].

4. Penas PF, Jones-Caballero M, Fraga J, Sanchez-Perez J, Garcia-Diez A. Perforating granuloma annulare. Int J Dermatol. 1997 May. 36(5):340-8. [QxMD MEDLINE Link].

5. Ghadially R. Granuloma annulare, actinic granuloma. Arndt K, et al, eds. Cutaneous Medicine and Surgery. WB Saunders Co; 1996. 438-443.

6. Mehta LR, Rose JW. Recurrent granuloma annulare during treatment with daclizumab. Mult Scler. 2009 Apr. 15(4):527-8. [QxMD MEDLINE Link].

7. Cornejo CM, Haun P, English J 3rd, Rosenbach M. Immune checkpoint inhibitors and the development of granulomatous reactions. J Am Acad Dermatol. 2019 Nov. 81 (5):1165-1175. [QxMD MEDLINE Link].

8. Fontecilla NM, Kittler NW, Lopez A, Yang C, Geskin L. Programmed cell death protein-1 inhibitor-induced granuloma annulare and hypertrophic lichen planus masquerading as squamous cell carcinoma. JAAD Case Rep. 2018 Aug. 4 (7):636-639. [QxMD MEDLINE Link].

9. Wu J, Kwong BY, Martires KJ, Rieger KE, Chung WH, Iyer GV, et al. Granuloma annulare associated with immune checkpoint inhibitors. J Eur Acad Dermatol Venereol. 2018 Apr. 32 (4):e124-e126. [QxMD MEDLINE Link].

10. Kakourou T, Psychou F, Voutetakis A, Xaidara A, Stefanaki K, Dacou-Voutetakis C. Low serum insulin values in children with multiple lesions of granuloma annulare: a prospective study. J Eur Acad Dermatol Venereol. 2005 Jan. 19(1):30-4. [QxMD MEDLINE Link].

11. Li A, Hogan DJ, Sanusi ID, Smoller BR. Granuloma annulare and malignant neoplasms. Am J Dermatopathol. 2003 Apr. 25(2):113-6. [QxMD MEDLINE Link].

12. O'Brien JP, Regan W. Actinically degenerate elastic tissue is the likely antigenic basis of actinic granuloma of the skin and of temporal arteritis. J Am Acad Dermatol. 1999 Feb. 40(2 Pt 1):214-22. [QxMD MEDLINE Link].

13. De Maeseneer M, Vande Walle H, Lenchik L, Machiels F, Desprechins B. Subcutaneous granuloma annulare: MR imaging findings. Skeletal Radiol. 1998 Apr. 27(4):215-7. [QxMD MEDLINE Link].

14. Shehan JM, El-Azhary RA. Magnetic resonance imaging features of subcutaneous granuloma annulare. Pediatr Dermatol. 2005 Jul-Aug. 22(4):377-8. [QxMD MEDLINE Link].

15. Blume-Peytavi U, Zouboulis CC, Jacobi H, Scholz A, Bisson S, Orfanos CE. Successful outcome of cryosurgery in patients with granuloma annulare. Br J Dermatol. 1994 Apr. 130(4):494-7. [QxMD MEDLINE Link].

16. Sniezek PJ, DeBloom JR 2nd, Arpey CJ. Treatment of granuloma annulare with the 585 nm pulsed dye laser. Dermatol Surg. 2005 Oct. 31 (10):1370-3. [QxMD MEDLINE Link].

17. Sliger BN, Burk CJ, Alvarez-Connelly E. Treatment of granuloma annulare with the 595 nm pulsed dye laser in a pediatric patient. Pediatr Dermatol. 2008 Mar-Apr. 25 (2):196-7. [QxMD MEDLINE Link].

18. Liu A, Hexsel CL, Moy RL, Ozog DM. Granuloma annulare successfully treated using fractional photothermolysis with a 1,550-nm erbium-doped yttrium aluminum garnet fractionated laser. Dermatol Surg. 2011 May. 37 (5):712-5. [QxMD MEDLINE Link].

19. Bronfenbrener R, Ragi J, Milgraum S. Granuloma annulare treated with excimer laser. J Clin Aesthet Dermatol. 2012 Nov. 5 (11):43-5. [QxMD MEDLINE Link].

20. Passeron T, Fusade T, Vabres P, Bousquet-Rouaud R, Collet-Vilette AM, Dahan S, et al. Treatment of granuloma annulare with the 595-nm pulsed dye laser, a multicentre retrospective study with long-term follow-up. J Eur Acad Dermatol Venereol. 2011 Dec 21. [QxMD MEDLINE Link].

21. Harth W, Linse R. Topical tacrolimus in granuloma annulare and necrobiosis lipoidica. Br J Dermatol. 2004 Apr. 150(4):792-4. [QxMD MEDLINE Link].

22. Jain S, Stephens CJ. Successful treatment of disseminated granuloma annulare with topical tacrolimus. Br J Dermatol. 2004 May. 150(5):1042-3. [QxMD MEDLINE Link].

23. Rigopoulos D, Prantsidis A, Christofidou E, Ioannides D, Gregoriou S, Katsambas A. Pimecrolimus 1% cream in the treatment of disseminated granuloma annulare. Br J Dermatol. 2005 Jun. 152(6):1364-5. [QxMD MEDLINE Link].

24. Lopez-Navarro N, Castillo R, Gallardo MA, Alcaide A, Matilla A, Herrera E. Successful treatment of perforating granuloma annulare with 0.1% tacrolimus ointment. J Dermatolog Treat. 2008. 19 (6):376-7. [QxMD MEDLINE Link].

25. Grieco T, Cantisani C, Faina P, Cantoresi F, Lacobellis F, Silvestri E, et al. Tacrolimus 0.1% and granuloma annulare: description of three cases. J Eur Acad Dermatol Venereol. 2009 Dec. 23 (12):1445-6. [QxMD MEDLINE Link].

26. Gomez-Moyano E, Vera-Casaño A, Martinez S, Sanz A. Periorbital granuloma annulare successfully treated with tacrolimus 0.1% ointment. Int J Dermatol. 2014 Feb. 53 (2):e156-7. [QxMD MEDLINE Link].

27. Kuwahara RT, Naylor MF, Skinner RB. Treatment of granuloma annulare with topical 5% imiquimod cream. Pediatr Dermatol. 2003 Jan-Feb. 20(1):90. [QxMD MEDLINE Link].

28. Badavanis G, Monastirli A, Pasmatzi E, Tsambaos D. Successful treatment of granuloma annulare with imiquimod cream 5%: a report of four cases. Acta Derm Venereol. 2005. 85(6):547-8. [QxMD MEDLINE Link].

29. Errichetti E, Stinco G, Pegolo E, Patrone P. Generalized Granuloma Annulare in a Cirrhotic Patient Treated with Narrowband Ultraviolet B Therapy. Indian J Dermatol. 2016 Jan-Feb. 61 (1):127. [QxMD MEDLINE Link].

30. Ine K, Kabashima K, Koga C, Kobayashi M, Tokura Y, Kabashima K. Eruptive generalized granuloma annulare presenting with numerous micropapules. Int J Dermatol. 2010 Jan. 49 (1):104-5. [QxMD MEDLINE Link].

31. Inui S, Nishida Y, Itami S, Katayama I. Disseminated granuloma annulare responsive to narrowband ultraviolet B therapy. J Am Acad Dermatol. 2005 Sep. 53 (3):533-4. [QxMD MEDLINE Link].

32. Samson Yashar S, Gielczyk R, Scherschun L, Lim HW. Narrow-band ultraviolet B treatment for vitiligo, pruritus, and inflammatory dermatoses. Photodermatol Photoimmunol Photomed. 2003 Aug. 19 (4):164-8. [QxMD MEDLINE Link].

33. Yong A, Chong WS, Pan JY. Disseminated granuloma annulare responding to narrowband UVB phototherapy. Photodermatol Photoimmunol Photomed. 2016 Mar. 32 (2):107-9. [QxMD MEDLINE Link].

34. Mikami E, Yanase M, Ito M, Kanzaki A, Saeki H. Generalized granuloma annulare successfully treated with narrowband ultraviolet B and anti-hepatitis C virus therapy. J Dermatol. 2016 Feb 19. [QxMD MEDLINE Link].

35. Pavlovsky M, Samuelov L, Sprecher E, Matz H. NB-UVB phototherapy for generalized granuloma annulare. Dermatol Ther. 2015 Dec 2. [QxMD MEDLINE Link].

36. Kerker BJ, Huang CP, Morison WL. Photochemotherapy of generalized granuloma annulare. Arch Dermatol. 1990 Mar. 126(3):359-61. [QxMD MEDLINE Link].

37. Batchelor R, Clark S. Clearance of generalized papular umbilicated granuloma annulare in a child with bath PUVA therapy. Pediatr Dermatol. 2006 Jan-Feb. 23 (1):72-4. [QxMD MEDLINE Link].

38. Grundmann-Kollmann M, Ochsendorf FR, Zollner TM, Tegeder I, Kaufmann R, Podda M. Cream psoralen plus ultraviolet A therapy for granuloma annulare. Br J Dermatol. 2001 May. 144 (5):996-9. [QxMD MEDLINE Link].

39. Browne F, Turner D, Goulden V. Psoralen and ultraviolet A in the treatment of granuloma annulare. Photodermatol Photoimmunol Photomed. 2011 Apr. 27 (2):81-4. [QxMD MEDLINE Link].

40. Looney M, Smith KM. Isotretinoin in the treatment of granuloma annulare. Ann Pharmacother. 2004 Mar. 38(3):494-7. [QxMD MEDLINE Link].

41. Schleicher SM, Milstein HJ. Resolution of disseminated granuloma annulare following isotretinoin therapy. Cutis. 1985 Aug. 36 (2):147-8. [QxMD MEDLINE Link].

42. Schleicher SM, Milstein HJ, Lim SJ, Stanton CD. Resolution of disseminated granuloma annulare with isotretinoin. Int J Dermatol. 1992 May. 31 (5):371-2. [QxMD MEDLINE Link].

43. Tang WY, Chong LY, Lo KK. Resolution of generalized granuloma annulare with isotretinoin therapy. Int J Dermatol. 1996 Jun. 35 (6):455-6. [QxMD MEDLINE Link].

44. Sahin MT, Türel-Ermertcan A, Oztürkcan S, Türkdogan P. Generalized granuloma annulare in a patient with type II diabetes mellitus: successful treatment with isotretinoin. J Eur Acad Dermatol Venereol. 2006 Jan. 20 (1):111-4. [QxMD MEDLINE Link].

45. Pasmatzi E, Georgiou S, Monastirli A, Tsambaos D. Temporary remission of disseminated granuloma annulare under oral isotretinoin therapy. Int J Dermatol. 2005 Feb. 44 (2):169-71. [QxMD MEDLINE Link].

46. Adams DC, Hogan DJ. Improvement of chronic generalized granuloma annulare with isotretinoin. Arch Dermatol. 2002 Nov. 138 (11):1518-9. [QxMD MEDLINE Link].

47. Grewal SK, Rubin C, Rosenbach M. Antimalarial therapy for granuloma annulare: Results of a retrospective analysis. J Am Acad Dermatol. 2017 Apr. 76 (4):765-767. [QxMD MEDLINE Link].

48. Cannistraci C, Lesnoni La Parola I, Falchi M, Picardo M. Treatment of generalized granuloma annulare with hydroxychloroquine. Dermatology. 2005. 211 (2):167-8. [QxMD MEDLINE Link].

49. Simon M Jr, von den Driesch P. Antimalarials for control of disseminated granuloma annulare in children. J Am Acad Dermatol. 1994 Dec. 31 (6):1064-5. [QxMD MEDLINE Link].

50. Piaserico S, Zattra E, Linder D, Peserico A. Generalized granuloma annulare treated with methylaminolevulinate photodynamic therapy. Dermatology. 2009. 218(3):282-4. [QxMD MEDLINE Link].

51. Weisenseel P, Kuznetsov AV, Molin S, Ruzicka T, Berking C, Prinz JC. Photodynamic therapy for granuloma annulare: more than a shot in the dark. Dermatology. 2008. 217(4):329-32. [QxMD MEDLINE Link].

52. Calzavara-Pinton PG, Rossi MT, Sala R, Italian Group For Photodynamic Therapy. A retrospective analysis of real-life practice of off-label photodynamic therapy using methyl aminolevulinate (MAL-PDT) in 20 Italian dermatology departments. Part 2: oncologic and infectious indications. Photochem Photobiol Sci. 2013 Jan. 12 (1):158-65. [QxMD MEDLINE Link].

53. Marcus DV, Mahmoud BH, Hamzavi IH. Granuloma annulare treated with rifampin, ofloxacin, and minocycline combination therapy. Arch Dermatol. 2009 Jul. 145(7):787-9. [QxMD MEDLINE Link].

54. Garg S, Baveja S. Monthly rifampicin, ofloxacin, and minocycline therapy for generalized and localized granuloma annulare. Indian J Dermatol Venereol Leprol. 2015 Jan-Feb. 81 (1):35-9. [QxMD MEDLINE Link].

55. Steiner A, Pehamberger H, Wolff K. Sulfone treatment of granuloma annulare. J Am Acad Dermatol. 1985 Dec. 13 (6):1004-8. [QxMD MEDLINE Link].

56. Czarnecki DB, Gin D. The response of generalized granuloma annulare to dapsone. Acta Derm Venereol. 1986. 66 (1):82-4. [QxMD MEDLINE Link].

57. Wolf F, Grezard P, Berard F, Clavel G, Perrot H. Generalized granuloma annulare and hepatitis B vaccination. Eur J Dermatol. 1998 Sep. 8 (6):435-6. [QxMD MEDLINE Link].

58. Saied N, Schwartz RA, Estes SA. Treatment of generalized granuloma annulare with dapsone. Arch Dermatol. 1980 Dec. 116 (12):1345-6. [QxMD MEDLINE Link].

59. Visconti MJ, Ashack KA, Ashack RJ. Granuloma annulare: strengthening potential associations and pentoxifylline as a therapeutic option. J Dermatolog Treat. 2019 Sep 10. 1-2. [QxMD MEDLINE Link].

60. Wong GN, Wee E, Tam M, Kelly R. Pentoxifylline as a treatment for granuloma annulare. Australas J Dermatol. 2019 Nov. 60 (4):328-331. [QxMD MEDLINE Link].

61. Weber HO, Borelli C, Rocken M, Schaller M. Treatment of disseminated granuloma annulare with low-dose fumaric acid. Acta Derm Venereol. 2009. 89(3):295-8. [QxMD MEDLINE Link].

62. Shupack J, Siu K. Resolving granuloma annulare with etanercept. Arch Dermatol. 2006 Mar. 142 (3):394-5. [QxMD MEDLINE Link].

63. Kreuter A, Altmeyer P, Gambichler T. Failure of etanercept therapy in disseminated granuloma annulare. Arch Dermatol. 2006 Sep. 142 (9):1236-7; author reply 1237. [QxMD MEDLINE Link].

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66. Hertl MS, Haendle I, Schuler G, Hertl M. Rapid improvement of recalcitrant disseminated granuloma annulare upon treatment with the tumour necrosis factor-alpha inhibitor, infliximab. Br J Dermatol. 2005 Mar. 152 (3):552-5. [QxMD MEDLINE Link].

67. Murdaca G, Colombo BM, Barabino G, Caiti M, Cagnati P, Puppo F. Anti-tumor necrosis factor-α treatment with infliximab for disseminated granuloma annulare. Am J Clin Dermatol. 2010 Dec 1. 11 (6):437-9. [QxMD MEDLINE Link].

68. Amy de la Breteque M, Saussine A, Rybojad M, Kramkimel N, Vignon Pennamen MD, Bagot M, et al. Infliximab in recalcitrant granuloma annulare. Int J Dermatol. 2016 Feb. 55 (2):220-2. [QxMD MEDLINE Link].

69. Rosmarin D, LaRaia A, Schlauder S, Gottlieb AB. Successful treatment of disseminated granuloma annulare with adalimumab. J Drugs Dermatol. 2009 Feb. 8(2):169-71. [QxMD MEDLINE Link].

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Ruby Ghadially, MBChB, FRCP(C)Derm Professor, Department of Dermatology, University of California, San Francisco, School of Medicine

Ruby Ghadially, MBChB, FRCP(C)Derm is a member of the following medical societies: American Academy of Dermatology, Ontario Medical Association, Royal College of Physicians and Surgeons of Canada, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Akos Z Szabo, MD Resident Physician, Department of Obstetrics and Gynecology, University of Heidelberg Medical Center, Germany

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steven R Feldman, MD, PhD Professor, Departments of Dermatology, Pathology and Public Health Sciences, and Molecular Medicine and Translational Science, Wake Forest Baptist Health; Director, Center for Dermatology Research, Director of Industry Relations, Department of Dermatology, Wake Forest University School of Medicine

Steven R Feldman, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, North Carolina Medical Society, Society for Investigative Dermatology

Disclosure: Received honoraria from Amgen for consulting; Received honoraria from Abbvie for consulting; Received honoraria from Galderma for speaking and teaching; Received consulting fee from Lilly for consulting; Received ownership interest from www.DrScore.com for management position; Received ownership interest from Causa Reseasrch for management position; Received grant/research funds from Janssen for consulting; Received honoraria from Pfizer for speaking and teaching; Received consulting fee from No.

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Arash Taheri, MD Research Fellow, Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine

Disclosure: Nothing to disclose.

Amit Garg, MD Director of Clinical Elective in Dermatology, Assistant Professor, Department of Internal Medicine, Division of Dermatology, University of Massachusetts Medical School

Amit Garg, MD is a member of the following medical societies: American Academy of Dermatology and American Medical Student Association/Foundation

Disclosure: Abbott Immunology Honoraria Speaking and teaching; Centocor Grant/research funds Other; RegenRx Grant/research funds Other

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