A 68-year-old man was referred with interstitial granulomatous dermatitis with arthritis involving a large area of his skin. Different treatment approaches remained unsuccessful. Finally, we initiated a treatment with tocilizumab. The response was promising.
A 68-year-old man presented with disseminated erythematous and flesh-colored, linearly arranged papules on the upper and lower extremities and the trunk (Figure 1). In contrast to granuloma anulare, severe generalized pruritus and pain characterized his lesions. Associated symptoms included severe symmetrical pain at his shoulders, hips, thighs, finger joints, and hands with morning stiffness. He also reported night sweats, recurring fever, and weight loss of 7 kg. His medical history revealed chronic kidney disease stage IV, coronary heart disease, and 2 completely excised basal cell carcinomas.
Schanz S, Schmalzing M, Guenova E, Metzler G, Ulmer A, K ötter I, Fierlbeck G. Interstitial Granulomatous Dermatitis With Arthritis Responding to Tocilizumab. Arch Dermatol. 2012;148(1):17-20. doi:10.1001/archdermatol.2011.341