Disseminated granuloma annulare responding to narrowband UVB phototherapy

Yong, Adeline Mei-Yen; Chong, Wei‐Sheng; Pan, Jiun Yit

doi:10.1111/phpp.12223

Cited by 3 publications

(8 citation statements)

References 8 publications

(6 reference statements)

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“…3 NBUVB has also been found superior to both broadband ultraviolet B and ultraviolet A in the suppression of cytokine and lymphocyte proliferation-the suppression of which has been proposed to thwart granuloma formation in DGA. 5,6 The role of NBUVB in the treatment of DGA in our context has also been similarly supported by previous case reports. 6 Koebnerisation is a phenomenon that can be seen in both cutaneous sarcoidosis and tattoo granulomas, when lesions occur at previous sites of cutaneous injury.…”

supporting

confidence: 89%

“…5,6 The role of NBUVB in the treatment of DGA in our context has also been similarly supported by previous case reports. 6 Koebnerisation is a phenomenon that can be seen in both cutaneous sarcoidosis and tattoo granulomas, when lesions occur at previous sites of cutaneous injury. However, our patient's rash was not solely confined to the tattoo sites, and there were no temporal sequelae (Table 1).…”

supporting

confidence: 89%

“…Treatment is guided by expert opinion and existing literature, which remains mostly limited to case reports. [2][3][4][5][6] Phototherapy has immunomodulatory effects, and has been proposed to play a role in the inhibition of T-lymphocytes, which are key in the pathogenesis of DGA. 3 In addition, phototherapy is an advantageous modality over other systemic therapies such as isotretinoin, biologics or fumaric acid esters due to its relatively safer side effect profile.…”

mentioning

confidence: 99%

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An intensely pruritic disseminated skin eruption

Hui

Chan

Pang

2022

Ann Acad Med Singap

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supporting

confidence: 89%

supporting

confidence: 89%

mentioning

confidence: 99%

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An intensely pruritic disseminated skin eruption

Hui

Chan

Pang

2022

Ann Acad Med Singap

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“…After title and abstract screening of 452 articles and full‐text review of 45 articles, 31 articles were ultimately included in our review (Figure 1). 10‐45 Two studies of which were conference abstracts and five not in the English language. Studies were published between 1988 and 2020 and included 31 case series (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies reported on PUVA therapy in patients with GA (Table ), representing a pooled sample size of 131 patients, with a mean age of 60.5 years (6–89) and available data showed 76% ( n = 80/105) were female 10,11,22,25,27,29,30,32‐37 . Overall, PUVA showed complete response in 59% ( n = 77/131) of patients with GA in mean 2.1 months, partial response in 25% (n = 33/131) in mean 2.2 months, and no response in 16% ( n = 21/131) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Light‐ and laser‐based treatments for granuloma annulare: A systematic review

Mukovozov

Kashetsky

Richer

2021

Photoderm Photoimm Photomed

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Background: Granuloma annulare (GA) is challenging to treat, especially when generalized. A systematic review to support the use of light-and laser-based treatments for GA is lacking. Methods:We performed a systematic review by searching Cochrane, MEDLINE, and Embase. Title, abstract, full-text screening, and data extraction were done in duplicate. Quality appraisal was performed using the Joanna Briggs Institute critical appraisal tool for case series.Results: Thirty-one case series met the inclusion criteria, representing a total of 336 patients. Overall, psoralen ultraviolet light A (PUVA) showed the greatest frequency of cases with complete response (59%, n = 77/131), followed by photodynamic therapy (PDT) (52%, n = 13/25), ultraviolet light B (UVB)/narrowband UVB (nbUVB)/excimer laser (40%, n = 19/47), UVA1 (31%, n = 27/86), and lasers (29%, n = 8/28). Overall across treatment modalities, higher response rates were seen in localized GA compared to generalized GA. Conclusions:The body of evidence for light-and laser-based treatment of GA is sparse. Our results suggest that PUVA has a high clearance rate for GA but its use may be limited by concerns of carcinogenesis. Although PDT has the second highest clearance rate, adverse effects, small sample sizes, impractical treatment delivery (especially with generalized disease), and long-term concerns of carcinogenesis may limit its use. Although UVB/nbUVB/excimer laser appeared slightly less effective than other light therapies, we recommend UVB/nbUVB/excimer laser therapy as a first-line treatment for patients with generalized GA given wider availability and a favorable long-term safety profile.

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Narrowband Ultraviolet B Phototherapy for Generalized Granuloma Annulare: Real-Life Experience and Review of the Literature

Acer,

Kaya Erdoğan,

Ağaoğlu

et al. 2024

J Cutan Med Surg

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Introduction: Generalized granuloma annulare (GA) is an uncommon noninfectious granulomatous dermatitis. Phototherapy is often considered first-line therapy, with more evidence for psoralen ultraviolet A than narrowband ultraviolet B (NB-UVB). We aimed to evaluate the effectiveness and safety of NB-UVB in generalized GA and to review the literature. Materials and Methods: In this observational, retrospective study, 11 patients with generalized GA who received NB-UVB between 2013 and 2023 were evaluated. Data from the patients were obtained from the phototherapy unit and clinical follow-up forms. Results: Eleven patients, 10 (90.9%) female and 1 (9.1%) male were included in the study. The mean age of the patients was 57.6 ± 7.9 years. The mean disease duration was 26.9 ± 27.9 weeks. Three (27.2%) of the patients had interstitial GA. All patients showed improvement: NB-UVB therapy resulted in complete response in 18.2% of the patients and partial response in 81.8%. The mean number of NB-UVB sessions was 36.4 ± 13.8. The mean cumulative dose was 37.1 ± 25.6 J/cm2. There was no significant difference in the mean number of sessions and cumulative dose according to clinical response ( P > .05). NB-UVB was extremely well tolerated. After phototherapy, patients were followed for at least 6 months; no relapses were observed. Conclusion: NB-UVB is an effective and safe treatment option in generalized GA.

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Disseminated granuloma annulare responding to narrowband UVB phototherapy

Cited by 3 publications

References 8 publications

An intensely pruritic disseminated skin eruption

An intensely pruritic disseminated skin eruption

Light‐ and laser‐based treatments for granuloma annulare: A systematic review

Narrowband Ultraviolet B Phototherapy for Generalized Granuloma Annulare: Real-Life Experience and Review of the Literature

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