[Clinical variables and management of disseminated granuloma annulare - monocentric retrospective analysis of 33 cases between 2021 and 2023].

Abstract

Background and objectives: Granuloma annulare (GA) is a noninfectious, granulomatous dermatosis that is generally localized and self-limiting. In 15% of cases, the disease disseminates with protracted trajectories. This study aims to characterise the patient population with disseminated GA at a German university hospital and to explore treatment modalities.

Materials and methods: A retrospective monocentric evaluation was conducted at the University Hospital Regensburg between 2021 and 2023 with descriptive statistical analysis of the patient population and the treatment modalities used.

Results: During the specified period, 239 patients with GA were identified, 33 of whom had histologically confirmed disseminated GA. Of the patients, 25 (76%) were women. Average age was 57.4 ± 14.4 years. Furthermore 17 patients (53%) denied symptoms. Common symptoms included dysesthesia, itching and pain. Frequent concomitant diseases were diabetes mellitus, thyroid disease, atopic dermatitis and coronary heart disease. Topical glucocorticoids, systemic glucocorticoids, phototherapy, topical calcineurin inhibitors and dimethyl fumarate were used therapeutically in descending frequency. Only 6 patients (18%) showed partial or complete remission.

Conclusion: Due to the lack of approved therapies, disseminated GA is treated with inadequately effective regimens. Prospective randomized placebo-controlled trials are needed to investigate the efficacy of novel targeted therapies.