Medication Summary
Granuloma annulare
Medical treatments such as corticosteroids, potassium iodide, dapsone, niacinamide, chlorambucil, and isotretinoin have been tried, but none has been shown efficacious. Other treatments include liquid nitrogen cryotherapy, oral and topical PUVA photochemotherapy, UVA1 phototherapy, and cyclosporin. Isotretinoin should be reserved for patients with disseminated or refractory granuloma annulare because of potential serious toxicity. [13] Disseminated granuloma, which may be resistant to therapy, was responsive to low-dose fumaric acid esters in 63% of a series reported. [14] Moreover, adalimumab has been shown to be potentially promising to treat interstitial granuloma annulare. [15]
Corticosteroids
Class Summary
Corticosteroids are used for their potent anti-inflammatory activity.
Triamcinolone acetonide (Aristospan)
Triamcinolone acetonide treats inflammatory lesions that are responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.
Retinoids
Class Summary
Isotretinoin may have proliferative and inhibitory effects on collagen synthesis that may ameliorate symptoms associated with granuloma annulare.
Isotretinoin (Amnesteem, Claravis, Sotret)
Isotretinoin has been used as chemoprophylaxis of skin cancers.
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Granuloma annulare. Courtesy of Wikimedia Commons (Mierlo at English Wikipedia).
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Pyogenic granulomas are usually solitary lesions. The fingers and hands are common locations for these to develop. A history of minor trauma at the site shortly before development of the lesion is frequent.
