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March 2006

Resolving Granuloma Annulare With Etanercept

Arch Dermatol. 2006;142(3):393-403. doi:10.1001/archderm.142.3.394

Granuloma annulare (GA) is a benign, self-limited dermatosis that causes mild to severe cosmetic disfigurement. Treatment with topical or intralesional steroids may be effective, but long-term use can result in local and systemic adverse effects. Topical therapy with medications such as tacrolimus and imiquimod has met with isolated, modest success. One study, involving 3 patients, showed complete clearing of disseminated GA with zileuton and vitamin E therapy.1 Widespread disease has shown varied responsiveness to treatment with psoralen–UV-A, retinoids, cyclosporine, dapsone, and fumaric acid esters. T-cell–directed therapies show promise, with several cases of disseminated or recalcitrant GA having been successfully treated with the tumor necrosis factor α inhibitor infliximab or the T-cell modulator efalizumab.2,3 Intralesional therapy with human interferon gamma was effective in several cases of localized GA.4 We report a case of disseminated GA that responded to etanercept therapy.

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