Treatment of Generalized Granuloma annulare with Hydroxychloroquine

Cannistraci, Carlo Vittorio; Parola, Ilaria Lesnoni La; Falchi, Mario; Picardo, Mauro

doi:10.1159/000086452

Cited by 36 publications

(17 citation statements)

References 7 publications

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“…The main side effects associated with FAEs include gastrointestinal, flushing, reversible elevation of transaminases, lymphocytopenia, and eosinophilia. 125 Antimalarials are often used in the treatment of generalized GA. Chloroquine (250 mg daily) was successfully used in a patient with photodistributed GA. 126 Hydroxychloroquine has been used in the treatment of generalized GA. 127,128 Cannistraci and colleagues 127 treated 9 patients with generalized GA with 4 months of hydroxychloroquine (9 mg/kg/d for 2 months; 6 mg/kg/d for month 3; and 2 mg/kg/d for month 4). In this series of patients, complete remission was seen in all patients within 6 to 7 weeks of initiation of therapy.…”

Section: Evaluation and Managementmentioning

confidence: 99%

“…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%

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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: 99%

Section: Evaluation and Managementmentioning

confidence: 99%

Granuloma Annulare

Keimig

2015

Dermatologic Clinics

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“…Bu bildiride 2 yıllık gözlem sürecinde olgularda nüks bildirilmemiştir. Bunun yanında hidroksiklorokin farklı olgu sunumlarında da başarılı olarak bildirilmiştir (8,9).…”

Section: Discussionunclassified

Patch Type Granuloma Annulare Imitating Cutaneous T-Cell Lymphoma

Kaçar¹,

Özuğuz²,

Aktepe³

et al. 2015

tdd

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“…În forma generalizată de GI, prima linie de tratament este reprezentată de dermatocorticoizi și corticosteroizi intralezional, inhibitori topici de calcineurină sau fototerapie (27)(28). Terapiile sistemice presupun administrarea de hidroxiclorochină, isotretinoin sau dapsonă (29)(30)(31)(32).…”

Section: Managementul Giunclassified

Provocările terapeutice ale unui „mare imitator“ – granulomul inelar generalizat

Şandru¹,

Dermatologie²,

Popa³

et al. 2019

Ro Med J.

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REzumatGranulomul inelar (GI) reprezintă o patologie cutanată benignă, de etiologie necunoscută. Se poate manifesta sub mai multe forme clinice: localizat, generalizat, subcutanat sau perforant. Asocierea dintre GI și diabetul zaharat, dislipidemie sau neoplasme nu este încă elucidată. Deși diagnosticul este în mare parte clinic, uneori poate fi necesar examenul histopatologic. Prezentăm cazul unei paciente în vârstă de 52 de ani, diabetică, hipertensivă, care a dezvoltat o erupție maculă-papuloasă, pruriginoasă, localizată pe membrele inferioare și abdomen, în evoluție de 6 luni. Am efectuat biopisie cutanată cu examen histopatologic, care a relevat infiltrate nodulare dermice alcătuite din histiocite palisadate în jurul unor colecții de mucine și însoțite de limfocite cu dispoziție perivasculară, modificări tipice pentru o leziune de granulom inelar. Am inițiat tratament sistemic cu isotretinoin, asociat cu dermatocorticoizi, cu evoluție favorabilă. Atât diagnosticul, cât și managementul unei pacient cu GI generalizat pot fi uneori dificile. Examenul histopatologic, în asociere cu un tablou clinic sugestiv, tranșează diagnosticul. Tratamentul se indică în cazurile severe, cu leziuni multiple, simptomatice, persistente.Cuvinte cheie: granulom inelar, isotretinoin, dermatocorticoizi, dapsonă aBStRaCt Granuloma annulare (GA) is a benign skin condition of unknown etiology. It can manifest itself in several clinical forms: localized, generalized, subcutaneous or perforating. The association between GI and diabetes, dyslipidemia or neoplasms is not yet elucidated. Although the diagnosis is clinical in most cases, a histopathological examination may be necessary. We presented the case of a 52 years old patient, diabetic, hypertensive, who reffered to our clinic, with a rash or macular-papular, pruritic, eruption, localization on the lower limbs and abdomen, in the evolution of 6 months. We performed skin biopsy with histopathological examination, which revealed: dermal nodular infiltrates consisting of palisadiate histiocytes, in several mucin collections and signified by lymphocytes with perivascular arrangement, typical modifications for an annular granuloma lesion. We have initiated systemic treatment with isotretinoin, associated with dermatocorticoids, with favorable evolution. Diagnosis, aș well aș the management of a patient with generalized GI, can sometimes be difficult. The histopathological examination, in combination with a suggestive clinical picture, makes the diagnosis. Treatment is indicated in severe cases, with multiple, symptomatic, persistent lesions.

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Treatment of Generalized Granuloma annulare with Hydroxychloroquine

Cited by 36 publications

References 7 publications

Granuloma Annulare

Granuloma Annulare

Patch Type Granuloma Annulare Imitating Cutaneous T-Cell Lymphoma

Provocările terapeutice ale unui „mare imitator“ – granulomul inelar generalizat

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