Disseminated Granuloma Annulare Resolved With the T-Cell Modulator Efalizumab

Shedding Light on Photodynamic Therapy in the Treatment of Necrobiosis Lipoidica: A Multicenter Real-Life Experience

“…PDT promotes the production of MMP in fibroblasts, leading to enhanced levels of MMP-1, MMP-9, and transforming growth factor (TGF)-β3 in treated wounds compared to untreated wounds [69,70]. Moreover, building upon the study by Kim et al [71], who successfully treated granuloma annulare-a granulomatous condition sharing similarities with NL-with PDT, it can be hypothesized that PDT may also be effective in NL through the accumulation of the photosensitizer in lymphatic infiltrates and inhibition of T-cell proliferation [72]. Regarding this topic, disorders with chronic granulomatous inflammation and/or degenerative changes of collagen have been demonstrated to be highly responsive to PDT and very well tolerated with low pain and little local inflammation [32].…”

Generalized interstitial granuloma annulare – response to adalimumab

“…Encouraged by reports in the literature of successful treatments of disseminated GA with TNFα‐antagonists, which down‐regulate T H 1 cytokine production and consecutively decrease or suppress the underlying inflammatory process, 6,11–14 we decided to attempt treatment with adalimumab. In comparison with other reported cases, there might be a benefit for a higher starting dose resulting in a faster response to treatment (Table1).…”

Photodynamic Therapy of Necrobiosis Lipoidica – A Multicenter Study of 18 Patients

“…Kim et al [12] have used PDT to successfully cure granuloma annulare, a granulomatous disease with certain similarities to NL. Since the actual photosensitizer – protoporphyrin IX – has been shown to accumulate in lymphatic infiltrates and inhibit T-cell proliferation [13], it can be hypothesized that this mechanism was also effective in NL lesions treated with PDT.…”