Psoralen and ultraviolet A in the treatment of granuloma annulare

Browne, Fiona; Turner, David M.; Goulden, V.

doi:10.1111/j.1600-0781.2011.00574.x

Cited by 37 publications

(28 citation statements)

References 29 publications

(21 reference statements)

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“…[103][104][105] Psoralen-UV-A (PUVA) has been effective in clearing the lesions of GA in case reports and small case series. [106][107][108][109] As in the case of UV-A1 therapy, although many patients showed improvement, [106][107][108][109] recurrence was common and maintenance therapy was required. 107,109 One challenge with any form of phototherapy is the need for frequent and consistent office visits.…”

Section: Evaluation and Managementmentioning

confidence: 95%

“…Immunosuppression with methotrexate, cyclosporine, and TNF-a inhibitors can be considered in patients with severe disease that has been recalcitrant to other therapies. 28,[87][88][89][90][91][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][114][115][116][117][118][119][120][121][122][123][124]126,127,129,130,[132][133][134][140][141][142][144][145][146][147][148]150,…”

Section: Evaluation and Managementmentioning

confidence: 99%

See 1 more Smart Citation

Granuloma Annulare

Keimig

2015

Dermatologic Clinics

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Granuloma annulare (GA) is a noninfectious granulomatous skin condition that can present with a variety of cutaneous morphologies. It is characterized by collagen degeneration, mucin deposition, and palisaded or interstitial histiocytes. Although the mechanism underlying development of GA is unknown, studies point to a cell-mediated hypersensitivity reaction to an as-yet undetermined antigen. Systemic associations with diabetes, thyroid disorders, lipid abnormalities, malignancy, and infection are described in atypical GA. Treatment is divided into localized skin-directed therapies and systemic immunomodulatory or immunosuppressive therapies. The selected treatment modality should be based on disease severity, comorbid conditions, consideration of potential side effects, and patient preference.

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Section: Evaluation and Managementmentioning

confidence: 95%

Section: Evaluation and Managementmentioning

confidence: 99%

Granuloma Annulare

Keimig

2015

Dermatologic Clinics

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“…Both interstitial and palisaded patterns have been reported in GGA, with some studies showing palisaded pattern to be more common . The inflammatory cell infiltrate seen in GA is comprised of T lymphocytes and macrophages . This idiopathic reaction is believed to be a type‐IV hypersensitivity response to an unidentified antigen …”

Section: Introductionmentioning

confidence: 99%

Treatment of generalized granuloma annulare – a systematic review

Lukács

Schliemann

Elsner

2015

Acad Dermatol Venereol

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Granuloma annulare (GA) is a benign inflammatory skin disease. Localized GA is likely to resolve spontaneously, while generalized GA (GGA) is rare and may persist for decades. GGA usually is resistant to a variety of therapeutic modalities and takes a chronic course. The objective of this study was to summarize all reported treatments of generalized granuloma annulare. This is a systematic review based on MEDLINE, Embase and Cochrane Central Register search of articles in English and German and a manual search, between 1980 and 2013, to summarize the treatment of generalized granuloma annulare. Most medical literature on treatment of GGA is limited to individual case reports and small series of patients treated without a control group. Randomized controlled clinical studies are missing. Multiple treatment modalities for GGA were reported including topical and systemic steroids, PUVA, isotretinoin, dapsone, pentoxifylline, hydroxychloroquine, cyclosporine, IFN-γ, potassium iodide, nicotinamide, niacinamide, salicylic acid, dipyridamole, PDT, fumaric acid ester, etanercept, infliximab, adalimumab. While there are numerous case reports of successful treatments in the literature including surgical, medical and phototherapy options, well-designed, randomized, controlled clinical trials are required for an evidence-based treatment of GGA.

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“…showed that systemic or topical corticosteroids were more effective than dapsone, hydroxychloroquine, psoralen and ultraviolet A (PUVA), cyclosporine, or isotretinoin. Browne et al . showed good improvement of generalized GA in 66% of cases with PUVA, but prolonged remission occurred in less than one‐third of patients.…”

Section: Discussionmentioning

confidence: 87%