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American Journal of Clinical Dermatology
Erschienen in: American Journal of Clinical Dermatology 1/2022

08.09.2021 | Review Article

Granuloma Annulare: An Updated Review of Epidemiology, Pathogenesis, and Treatment Options

verfasst von: Tejas P. Joshi, Madeleine Duvic

Erschienen in: American Journal of Clinical Dermatology | Ausgabe 1/2022

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Abstract

Granuloma annulare (GA) is an inflammatory granulomatous skin disease that can be localized (localized GA) or disseminated (generalized GA), with patch, perforating, and subcutaneous subtypes being less common variants of this benign condition. Recently, new research has emerged that further elucidates GA epidemiology and etiopathogenesis; importantly, new therapeutic options for GA have also been described, although there remains a paucity of randomized controlled studies. In this review, we summarize recent updates on GA epidemiology and etiopathogenesis and offer an updated review of the therapeutic options for GA currently reported in the literature. We hope that the current review galvanizes randomized controlled studies that will in turn help lead to the recommendation of evidence-based treatments for GA.
Literatur
1.
Colcott-Fox T. Ringed eruptions of the fingers. Br J Dermatol. 1895;7:91–5.
2.
Little EG. Granuloma Annulare. Br J Dermatol. 1908;20:317–35.
3.
Piette EW, Rosenbach M. Granuloma annulare: pathogenesis, disease associations and triggers, and therapeutic options. J Am Acad Dermatol. 2016;75:467–79.PubMed
4.
Piette EW, Rosenbach M. Granuloma annulare: clinical and histologic variants, epidemiology, and genetics. J Am Acad Dermatol. 2016;75:457–65.PubMed
5.
Thornsberry LA, English JC III. Etiology, diagnosis, and therapeutic management of granuloma annulare: an update. Am J Clin Dermatol. 2013;14:279–90.PubMed
6.
Lukács J, Schliemann S, Elsner P. Treatment of generalized granuloma annulare—a systematic review. J Eur Acad Dermatol Venereol. 2015;29:1467–80.PubMed
7.
Keimig EL. Granuloma Annulare. Dermatol Clin. 2015;33:315–29.PubMed
8.
Wang J, Khachemoune A. Granuloma annulare: a focused review of therapeutic options. Am J Clin Dermatol. 2018;19:333–44.PubMed
9.
Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evidence-Based Med. 2018;23:60–3.
10.
Barbieri JS, Rodriguez O, Rosenbach M, Margolis D. Incidence and prevalence of granuloma annulare in the United States. JAMA Dermatol. 2021;157:824–30.PubMed
11.
12.
Endo Y, Sekiguchi A, Motegi S, Ishikawa O. Subcutaneous granuloma annulare on the heel: a case report and review of the Japanese published work. J Dermatol. 2020;47:677–9.PubMed
13.
Khanna U, North JP. Patch-type granuloma annulare: an institution-based study of 23 cases. J Cutan Pathol. 2020;47:785–93.PubMed
14.
Pap N, Bradamante M, Ljubojević HS. Localized perforating granuloma annulare. Acta Dermatovenerol Croat. 2019;27:33–6.PubMed
15.
Salzmann M, Rendon A, Toberer F, Hassel JC. Generalized perforating granuloma annulare: a case report. J Dtsch Dermatol Ges. 2021;19:585–7.PubMed
16.
Muse M, Prohaska J, Shah M, White W, Appel J. Granuloma annulare on the palms. Dermatol Online J. 2021;27:13030/qt0m50398n.
17.
18.
Chatterjee D, Kaur M, Punia RPS, Bhalla M, Handa U. Evaluating the unusual histological aspects of granuloma annulare: a study of 30 cases. Indian Dermatol Online J. 2018;9:409–13.PubMedPubMedCentral
19.
Hawryluk EB, Izikson L, English JC. Non-infectious granulomatous diseases of the skin and their associated systemic diseases: an evidence-based update to important clinical questions. Am J Clin Dermatol. 2010;11:171–81.PubMed
20.
Shibayama A, Sugita K, Narukawa K, Fujiwara Y, Goto H, Shiomi T, et al. Granuloma annulare can occur on a scar, mimicking sarcoidosis. Clin Exp Dermatol. 2017;42:920–1.PubMed
21.
Akay BN, Atak MF, Kirmizi A, Farabi B. Granuloma annulare mimicking eruptive dermatofibroma in an HIV-positive male: a challenge with distinct dermatoscopic findings. Dermatol Ther. 2020;33:e13375.PubMed
22.
Maoz K, Greenberger S, Maly A, Merims S, Tirosh I, Barzilai A, et al. Subcutaneous granuloma annulare mimicking dermatomyositis. Pediatr Dermatol. 2020;37:687–9.PubMed
23.
Chae MH, Shin JY, Lee JY, Yoon TY. Perforating granuloma annulare mimicking papulonecrotic tuberculid. Ann Dermatol. 2018;30:716–20.PubMedPubMedCentral
24.
25.
Witkoff BM, Ivanov NN, Trotter SC. Perforating granuloma annulare appearing as a psoriasiform lesion. Case Rep Dermatol. 2019;11:233–8.PubMedPubMedCentral
26.
Orleans RA, Magro CM, Varghese GI. A case of granuloma annulare mimicking tinea cruris. Dermatol Online J. 2018;24:13030/qt3kz6h4kj.
27.
Saggini A, Cerroni L. Cutaneous borreliosis: an insidious mimicker of patch-type granuloma annulare. J Cutan Pathol. 2020;47:876–8.PubMed
28.
Zhu H, Huang M, Huang W. Anti-neutrophil cytoplasmic antibodies-negative Churg-Strauss syndrome presenting as granuloma annulare-like lesions: an unusual cutaneous presentation and a diagnostic pitfall. Indian J Dermatol Venereol Leprol. 2021;87:259–62.PubMed
29.
Aghazadeh N, Bridges AG, Camilleri MJ, Peters MS, Comfere NI. Kaposi sarcoma misdiagnosed as granuloma annulare: a case of mistaken identity. J Cutan Pathol. 2021;48:318–21.PubMed
30.
Zhu TH, Kamangar F, Silverstein M, Fung MA. Borderline tuberculoid leprosy masquerading as granuloma annulare: a clinical and histological pitfall. Am J Dermatopathol. 2017;39:296–9.PubMed
31.
Errichetti E, Lallas A, Apalla Z, Di Stefani A, Stinco G. Dermoscopy of granuloma annulare: a clinical and histological correlation study. Dermatology. 2017;233:74–9.PubMed
32.
Errichetti E, Stinco G. Dermatoscopy of granulomatous disorders. Dermatol Clin. 2018;36:369–75.PubMed
33.
Vázquez-Osorio I, Quevedo A, Rodríguez-Vidal A, Rodríguez-Díaz E. Usefulness of ultrasonography in the diagnosis of subcutaneous granuloma annulare. Pediatr Dermatol. 2018;35:e200–1.PubMed
34.
Rodríguez Bandera AI, Stewart N, Beato MJ, de Lucas LR. Comment on “Usefulness of ultrasonography in the diagnosis of subcutaneous granuloma annulare.” Pediatr Dermatol. 2018;35:875–6.PubMed
35.
Min MS, Wu J, He H, Sanz-Cabanillas JL, Del Duca E, Zhang N, et al. Granuloma annulare skin profile shows activation of T-helper cell type 1, T-helper cell type 2, and Janus kinase pathways. J Am Acad Dermatol. 2020;83:63–70.PubMed
36.
Wang A, Rahman N-T, McGeary MK, Murphy M, McHenry A, Peterson D, et al. Treatment of granuloma annulare and suppression of proinflammatory cytokine activity with tofacitinib. J Allergy Clin Immunol. 2021;147:1795–809.PubMed
37.
Modlin RL, Horwitz DA, Jordan RR, Gebhard JF, Taylor CR, Rea TH. Immunopathologic demonstration of T lymphocyte subpopulations and interleukin 2 in granuloma annulare. Pediatr Dermatol. 1984;2:26–32.PubMed
38.
Modlin RL, Vaccaro SA, Gottlieb B, Gebhard JF, Linden CE, Forni M, et al. Granuloma annulare. Identification of cells in the cutaneous infiltrate by immunoperoxidase techniques. Arch Pathol Lab Med. 1984;108:379–82.PubMed
39.
Barbieri JS, Rosenbach M, Rodriguez O, Margolis DJ. Association of granuloma annulare with Type 2 Diabetes, hyperlipidemia, autoimmune disorders, and hematologic malignant neoplasms. JAMA Dermatol. 2021;157:817–23.PubMed
40.
41.
42.
Gabaldón VH, Haro-González-Vico V. Lack of an association between generalized granuloma annulare and malignancy: a case-control study. J Am Acad Dermatol. 2019;80:1799–800.PubMed
43.
Tolkki L, Hokynar K, Meri S, Panelius J, Puolakkainen M, Ranki A. Granuloma Annulare and Morphea: Correlation with Borrelia burgdorferi Infections and Chlamydia-related Bacteria. Acta Derm Venereol. 2018;98:355–60.PubMed
44.
Guglielmo A, Virdi A, Misciali C, Gabrielli L, Veronesi G, Corsini I, et al. Generalized granuloma annulare-like eruption secondary to acute Epstein-Barr virus infection. Int J Dermatol. 2021;60:e110–2.PubMed
45.
Mann E, Maruthi R, Friedland MH, Chung HJ, McGee JS. Case of post-herpetic, isotopic granuloma annulare (GA), followed by generalized GA. J Dermatol. 2019;46:e476–7.PubMed
46.
Al Ali A, Alkhodair R, Thuraisingam T, Gerstein W, Watters K. Multiple granuloma annulare lesions presenting simultaneously with herpes zoster infection: Wolf’s isotopic response. JAAD Case Rep. 2018;4:631–2.PubMedPubMedCentral
47.
García-Gil MF, Monte Serrano J, García García M, Matovelle Ochoa C, Ara-Martín M. Granuloma annulare triggered by SARS-CoV-2 infection. The first reported case. J Dermatol. 2021;48:e1-2.PubMed
48.
Monte-Serrano J, García-Gil MF, García-García M, Casas-Flecha I, Matovelle-Ochoa C, Ara-Martín M. Granuloma annulare triggered by SARS-CoV-2 infection: immunohistochemical staining. Dermatol Ther. 2021;34:e14897.PubMed
49.
Shah N, Shah M, Drucker AM, Shear NH, Ziv M, Dodiuk-Gad RP. Granulomatous cutaneous drug eruptions: a systematic review. Am J Clin Dermatol. 2021;22:39–53.PubMed
50.
Guimaraes MJ, Gomes J, Caldas R, Almeida F, Brito C. Subcutaneous granuloma annulare induced by acetazolamide. Pediatr Dermatol. 2020;37:1181–2.PubMed
51.
Fässler M, Schlapbach C. Granuloma annulare arising under systemic psoriasis therapy successfully treated with adalimumab. JAAD Case Rep. 2020;6:832–4.PubMedPubMedCentral
52.
Gray AR, Davies OMT, White K, Ortega-Loayza AG. Granuloma annulare following initiation of interleukin-17a antagonist. Clin Exp Dermatol. 2021;46:924–6.PubMed
53.
Robati RM, Bahmanjahromi A, Bidari-Zerehpoosh F. Periorbital granuloma annulare following mesotherapy. Dermatol Ther. 2020;33:e14326.PubMed
54.
Fonda-Pascual P, de Gálvez MV, Aguilera J, Herrera-Ceballos E. Photoinduced granuloma annulare confirmed by experimental exposure to UVA light. Actas Dermosifiliogr. 2021;112:190–2.PubMed
55.
56.
García-Gil MF, Álvarez-Salafranca M, Martínez García A, Ara-Martín M. Generalized granuloma annulare after pneumococcal vaccination. An Bras Dermatol. 2021;96:59–63.PubMed
57.
Nichani P, Micieli JA. Granuloma annulare, scalp necrosis, and ischemic optic neuropathy from giant cell arteritis after varicella-zoster virus vaccination. J Neuroophthalmol. 2021;41:e145–8.PubMed
58.
Rubin CB, Rosenbach M. Granuloma annulare: a retrospective series of 133 patients. Cutis. 2019;103:102–6.PubMed
59.
Nordmann TM, Kim J-R, Dummer R, Anzengruber F. A monocentric, retrospective analysis of 61 patients with generalized granuloma annulare. Dermatology. 2020;236:369–74.PubMed
60.
Visconti MJ, Ashack KA, Ashack RJ. Granuloma annulare: strengthening potential associations and pentoxifylline as a therapeutic option. J Dermatol Treat. 2021;32:381–2.
61.
Eid E, Zein-El-Dine S, Kurban M, Abbas O. Generalized granuloma annulare associated with interstitial lung disease: Good response to doxycycline. Dermatol Ther. 2021;34:e14864.PubMed
62.
Chandan N, Boen M, Lake EP, Aronson I. Successful treatment of two individual cases of generalized granuloma annulare with amoxicillin/clavulanic acid and a combination of doxycycline and pentoxifylline. Dermatol Online J. 2018;24:13030/qt9161p8z0.
63.
64.
65.
Megna M, Sidikov A, Ruggiero A, Fabbrocini G, Zaslavsky D, Nasyrov R, et al. A case of generalized granuloma annulare successfully treated by hydroxychloroquine. Dermatol Ther. 2020;33:e13894.PubMed
66.
Xu Q, Gu Y, Li Y, Ling B, Yu H, Yao Z. Concurrence of generalized perforating and subcutaneous granuloma annulare in a 4-year-old boy with latent tuberculosis infection successfully treated with low-dose hydroxychloroquine. J Dermatol. 2020;47:e71–2.PubMed
67.
68.
69.
Blum S, Altman D. Treatment of generalized granuloma annulare with apremilast: a report of 2 cases. JAAD Case Rep. 2019;5:976–8.PubMedPubMedCentral
70.
Bishnoi A, Raj D, Vinay K, Dogra S. Refractory Generalized Granuloma Annulare Treated With Oral Apremilast. JAMA dermatology (Chicago, IL). United States: American Medical Association; 2019;155:1318.
71.
72.
73.
Chen A, Truong AK, Worswick S. The role of biologics in the treatment of chronic granuloma annulare. Int J Dermatol. 2019;58:622–6.PubMed
74.
Antoñanzas J, Rodríguez-Garijo N, Tomás-Velázquez A, Estenaga A, Andrés-Ramos I, España AA. Treatment of recalcitrant reactive granulomatous dermatitis: Granuloma annulare subtype with etanercept. Dermatol Ther. 2020;33:e14081.PubMed
75.
Bürgler C, Vinay K, Häfliger S, Klötgen H-W, Yawalkar N. Infliximab reduces activated myeloid dendritic cells, different macrophage subsets and CXCR3-positive cells in granuloma annulare. J Dermatol. 2019;46:808–11.PubMed
76.
Song EJ, Bezecny J, Farrer S. Recalcitrant generalized granuloma annulare treated successfully with dupilumab. JAAD Case Rep. 2021;7:1–2.PubMed
77.
Song EJ. Tildrakizumab ineffective in generalized granuloma annulare. JAAD Case Rep. 2021;7:3–4.PubMed
78.
79.
Naka F, Strober BE. Methotrexate treatment of generalized granuloma annulare: a retrospective case series. J Dermatolog Treat. 2018;29:720–4.PubMed
80.
Hassan I, Dorjay K, Anwar P. Pentoxifylline and its applications in dermatology. Indian Dermatol Online J. 2014;5:510–6.PubMedPubMedCentral
81.
Wong GN, Wee E, Tam M, Kelly R. Pentoxifylline as a treatment for granuloma annulare. Australas J Dermatol. 2019;60:328–31.PubMed
82.
García-Malinis AJ, Gracia-Cazaña T, Planas Linares D, Agón-Banzo PJ, Gilaberte Y. Granuloma annulare: report of 13 patients treated with photodynamic therapy. J Eur Acad Dermatol Venereol. 2021;35:e211–4.PubMed
83.
Aichelburg MC, Pinkowicz A, Schuster C, Volc-Platzer B, Tanew A. Patch granuloma annulare: clinicopathological characteristics and response to phototherapy. Br J Dermatol. 2019;181:198–9.PubMedPubMedCentral
84.
Pitney T, Pitney MJ. A retrospective review of UVA1 treatment: an Australian experience from a single centre. Australas J Dermatol. 2020;61:318–23.PubMed
85.
Dawson A, Glassman SJ. Generalized granuloma annulare responsive to narrowband UVB. Cutis. 2019;103:E14–5.PubMed
86.
Muylaert BPB, Almada R, de Vasconcelos RCF. Granuloma annulare treated with narrowband UVB phototherapy. An Bras Dermatol. 2017;92:82–4.PubMedPubMedCentral
87.
88.
89.
Maloney NJ, Zhao J, Tegtmeyer K, Lee EY, Cheng K. Off-label studies on apremilast in dermatology: a review. J Dermatol Treat. 2020;31:131–40.
90.
Damsky W, Thakral D, McGeary MK, Leventhal J, Galan A, King B. Janus kinase inhibition induces disease remission in cutaneous sarcoidosis and granuloma annulare. J Am Acad Dermatol. 2020;82:612–21.PubMed
91.
Durgin JS, Shields BE, Rosenbach M. Generalized granuloma annulare: a widespread response to limited application of compounded 2% topical tofacitinib. JAAD Case Rep. 2020;6:1113–5.PubMedPubMedCentral
92.
Damsky W, King BA. Treatment of granuloma annulare with tofacitinib 2% ointment. JAAD Case Rep. 2020;6:69–71.PubMed
93.
Yang YW, Lehrer MD, Mangold AR, Yiannias JA, Nelson SA, Pittelkow MR. Treatment of granuloma annulare and related granulomatous diseases with sulphasalazine: a series of 16 cases. J Eur Acad Dermatol Venereol. 2021;35:211–5.PubMed
94.
Anzengruber F, Mergenthaler C, Murer C, Dummer R. Potassium Iodide for cutaneous inflammatory disorders: a monocentric. Retrospective Study. Dermatology. 2019;235:137–43.PubMed
95.
Mickel M, Kunstfeld R, Crevenna R. Granuloma annulare and radial pulse therapy: preliminary findings. J Clin Aesthet Dermatol. 2018;11:32–4.PubMedPubMedCentral
96.
Tsalamandris S, Antonopoulos AS, Oikonomou E, Papamikroulis G-A, Vogiatzi G, Papaioannou S, et al. The role of inflammation in diabetes: current concepts and future perspectives. Eur Cardiol. 2019;14:50–9.PubMedPubMedCentral
97.
Mailer RKW, Gisterå A, Polyzos KA, Ketelhuth DFJ, Hansson GK. Hypercholesterolemia enhances T cell receptor signaling and increases the regulatory T cell population. Sci Rep. 2017;7:15655.PubMedPubMedCentral
98.
Patrun S, Ljubojević HS. Unusual case of granuloma annulare associated with diabetes mellitus. Acta Dermatovenerol Croat. 2020;28:45–6.PubMed
99.
Virath R, Mehta S, Balai M, Meena M, Gupta LK. Eruptive Xanthoma and Granuloma Annulare in Association with Metabolic Disorder. Indian J Dermatol. 2021;66:199–201.PubMedPubMedCentral
100.
Damsker JM, Hansen AM, Caspi RR. Th1 and Th17 cells: adversaries and collaborators. Ann N Y Acad Sci. 2010;1183:211–21.PubMedPubMedCentral
101.
Min MS, Lebwohl M. Treatment of recalcitrant granuloma annulare (GA) with adalimumab: a single-center, observational study. J Am Acad Dermatol. 2016;74:127–33.PubMed
Metadaten
Titel
Granuloma Annulare: An Updated Review of Epidemiology, Pathogenesis, and Treatment Options
verfasst von
Tejas P. Joshi
Madeleine Duvic
Publikationsdatum
08.09.2021
Verlag
Springer International Publishing
Erschienen in
American Journal of Clinical Dermatology / Ausgabe 1/2022
Print ISSN: 1175-0561
Elektronische ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-021-00636-1

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