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Calzavara-Pinton P, Bettolini L, Tonon F, Rossi M, Venturini M. The realistic positioning of UVA1 phototherapy after 25 years of clinical experience and the availability of new biologics and small molecules: a retrospective clinical study. Front Med (Lausanne) 2023; 10:1295145. [PMID: 38076241 PMCID: PMC10702775 DOI: 10.3389/fmed.2023.1295145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/08/2023] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Since the early 1990s, Ultraviolet (UV) A1 phototherapy has been described as an effective and safe treatment of a multitude of skin disorders. However, after 30 years, its use has remained limited to few dermatological centers. OBJECTIVE To analyze the changes over the years and the current position of UVA1 phototherapy through a Real-World Evidence (RWE) study at a single tertiary referral center. METHODS We reviewed the medical files of 740 patients treated between 1998 and 2022. Treatment results were collected, efficacy was assessed by a grading scale and acute adverse effects were registered. RESULTS We treated patients with 26 different diseases. We registered marked improvement (MI) or complete remission (CR) in 42.8% of patients with morphea, 50% with Urticaria Pigmentosa, 40.7% with Granuloma annulare and 85.7% with skin sarcoidosis. Good results were obtained also in the treatment of chronic Graft Versus Host Disease (GVHD), Eosinophilic Fasciitis, Sclero-atrophic Lichen, skin manifestations of systemic lupus erythematosus and psoriasis of HIV+ patients. Systemic Sclerosis, Romberg's Syndrome, Bushke's Scleredema, Nephrogenic Fibrosing Dermopathy, REM Syndrome, Follicular Mucinosis, Pretibial Myxedema, Scleromyxedema, pemphigus foliaceus, chronic cutaneous lupus erythematosus, erythroderma of Netherton Syndrome and Necrobiosis Lipoidica were no or poorly responsive. In clinical indications where UVA1 was used as a second line phototherapy after narrow-band (NB)-UVB, we saw good MI or CR rates in Mycosis Fungoides (57% of patients), Atopic Dermatitis (33.9%), Pitiryasis Lichenoides chronica (50%), Pityriasis Lichenoides et varioliformis acute (75%) and Lymphomatod Papulosis (62.5%). Short-term adverse events were uncommon and mild. CONCLUSION Over the past decade, the annual number of treated patients has progressively declined for several reasons. Firstly, UVA1 phototherapy has taken a backseat to the cheaper and more practical NB-UVB phototherapy, which has proven effective for common indications. Secondly, the emergence of new, safe, and effective drugs for conditions such as atopic dermatitis, GVHD, and connective tissue disorders. Finally, our research has shown that UVA1 therapy is often ineffective or minimally effective for some rare diseases, contrary to previous case reports and small case series. Nonetheless, UVA1 continues to be a valuable treatment option for patients with specific skin disorders.
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Affiliation(s)
- Piergiacomo Calzavara-Pinton
- Department of Dermatology, University of Brescia, Brescia, Italy
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Luca Bettolini
- Department of Dermatology, University of Brescia, Brescia, Italy
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Francesco Tonon
- Department of Dermatology, University of Brescia, Brescia, Italy
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mariateresa Rossi
- Department of Dermatology, University of Brescia, Brescia, Italy
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Marina Venturini
- Department of Dermatology, University of Brescia, Brescia, Italy
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
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Kinberger M, Bonnekoh H, Dilling A, Meier K. [Granulomatous dermatoses]. Z Rheumatol 2022; 81:577-586. [PMID: 35854155 DOI: 10.1007/s00393-022-01239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
Abstract
The group of granulomatous dermatoses refers to a multitude of clinically different diseases, which are characterized by a histopathologically similar pattern of inflammation. The cause of granulomatous inflammatory reactions can be infections and also noninfectious stimuli, such as cell disintegration or foreign bodies. The aim of this immunological defence reaction is encapsulation in order to prevent further spread and delimitation from healthy tissue. This is histologically expressed as a granuloma in the sense of a circumscribed aggregation of histiocytes and multinucleated giant cells mostly in dermal connective tissue. The following can be histologically differentiated: sarcoid granuloma characterized by a sparse lymphocytic inflammatory infiltrate and tuberculous granuloma with central necrosis and denser lymphocytic inflammatory infiltrate. Neutrophilic granulocytes together with macrophages occur in suppurative granulomas and palisaded granulomas are characterized by peripherally arrayed macrophages.
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Affiliation(s)
- Maria Kinberger
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Hanna Bonnekoh
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Amrei Dilling
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
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Assi T, Danu A, Mateus C, Robert C, Michot JM, Ibrahim T, Lazarovici J, Ghez D, Rossignol J, Dartigues P, Terroir-Cassou-Mounat M, Ribrag V. Post-shingles granulomatous dermatosis related to anti-programmed cell death 1. Immunotherapy 2020; 11:591-598. [PMID: 30943861 DOI: 10.2217/imt-2018-0169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The most recent progress in the oncology field has led to a paradigm shift in the management of cancer with the tsunami of immune checkpoint inhibitors that are associated with a particular pattern of immunological adverse events. This is a case of a 54-year-old woman that demonstrated a granulomatous reaction in the same dermatomal distribution of a previously treated shingles infection during treatment with an anti-programmed death 1 agent (pembrolizumab) for a newly diagnosed stage IV Hodgkin lymphoma. The purpose of this case is to increase the awareness of oncologists dealing with a new pattern of side effects taking into account the patient's background and recent exposures to latent viruses such as herpes zoster to prevent unnecessary diagnostic and therapeutic measures.
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Affiliation(s)
- Tarek Assi
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alina Danu
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Christine Mateus
- Department of Dermatology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Caroline Robert
- Department of Dermatology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jean-Marie Michot
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Department of Drug Development (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Tony Ibrahim
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Julien Lazarovici
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - David Ghez
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Julien Rossignol
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Peggy Dartigues
- Department of Pathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Vincent Ribrag
- Department of Haematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Department of Drug Development (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Wang J, Khachemoune A. Granuloma Annulare: A Focused Review of Therapeutic Options. Am J Clin Dermatol 2018; 19:333-344. [PMID: 29230666 DOI: 10.1007/s40257-017-0334-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Granuloma annulare (GA) is a benign inflammatory disease associated with many conditions such as malignancy, trauma, thyroid disease, diabetes mellitus, and HIV infection. Common clinical subtypes include localized GA, generalized GA, subcutaneous GA, perforating GA, and patch GA. There exists an abundance of literature on GA, yet we know relatively little about its exact etiology and even less about its treatment. The paucity of conclusive data on effective treatment options is largely because the majority of published studies are limited to small case reports, case series, and retrospective studies. As such, there does not yet exist a gold standard of care to guide clinical management. Depending on the clinical subtype, the clinical prognosis for GA can vary. The localized variant generally self-resolves within 2 years without treatment, whereas the generalized form is more chronic and less responsive to treatment. This focused up-to-date review serves to summarize the latest therapeutic options available for GA.
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Herzinger T, Berneburg M, Ghoreschi K, Gollnick H, Hölzle E, Hönigsmann H, Lehmann P, Peters T, Röcken M, Scharffetter-Kochanek K, Schwarz T, Simon J, Tanew A, Weichenthal M. S1-Leitlinie zur UV-Phototherapie und Photochemotherapie. J Dtsch Dermatol Ges 2018; 14:e1-e25. [PMID: 27509439 DOI: 10.1111/ddg.12912_g] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Die heilsame Wirkung des Sonnenlichts war teilweise schon im Altertum bekannt und fand in der zweiten Hälfte des 19. Jahrhunderts wieder zunehmend Beachtung. Den Beginn der modernen Phototherapien markiert die Entwicklung einer Apparatur zur ultravioletten Bestrahlung der Hauttuberkulose durch Finnsen zu Beginn des zwanzigsten Jahrhunderts. Zur Therapie von Hauterkrankungen finden beinahe ausschließlich die spektralen Bereiche unterhalb des sichtbaren Lichtes (ultraviolett) Anwendung. Seit den 1970er Jahren stehen zunehmend leistungsfähige künstliche Strahlenquellen bereit für die Therapie mit UVB, UVA und die Kombination von UVA mit Photosensibilisatoren (Photochemotherapie). Hohe strukturelle und prozedurale Qualitätsstandards sind unabdingbare Voraussetzung für die Durchführung einer gleichermaßen wirkungsvollen wie auch sicheren Phototherapie. Die Leitlinie formuliert den aktuellen Konsens führender Experten auf dem Gebiet der Phototherapie in Bezug auf die Indikationen für die jeweiligen Therapieverfahren, deren Gegenanzeigen und Nebenwirkungen und insbesondere für die Wahl der korrekten Dosis zu Beginn und im Verlauf einer Therapie sowie das Management von Nebenwirkungen.
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Affiliation(s)
- Thomas Herzinger
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | - Mark Berneburg
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg
| | | | - Harald Gollnick
- Universitätsklinik für Dermatologie und Venerologie, Otto-von-Guericke-Universität Magdeburg
| | - Erhard Hölzle
- Klinik für Dermatologie und Allergologie, Klinikum Oldenburg
| | - Herbert Hönigsmann
- Universitätsklinik für Dermatologie, Allgemeines Krankenhaus der Stadt Wien
| | - Percy Lehmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, HELIOS-Klinikum Wuppertal
| | - Thorsten Peters
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Ulm
| | | | | | | | - Jan Simon
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig
| | - Adrian Tanew
- Universitätsklinik für Dermatologie, Allgemeines Krankenhaus der Stadt Wien
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Piette EW, Rosenbach M. Granuloma annulare. J Am Acad Dermatol 2016; 75:467-479. [DOI: 10.1016/j.jaad.2015.03.055] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/10/2015] [Accepted: 03/20/2015] [Indexed: 11/25/2022]
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Abstract
Granuloma annulare is a benign, chronic inflammatory skin disease. Its pathogenesis is still unclear, but reports on infections as a trigger can be found. In addition, some authors reported an association with other systemic disease, e.g., cancer, trauma, and diabetes mellitus; however, these have not been verified. The clinical picture of granuloma annulare ranges from the localized form predominantly at the extremities to disseminated, subcutaneous, or perforating forms. Diagnosis is based on the typical clinical presentation which may be confirmed by a biopsy. Histologically, necrobiotic areas within granulomatous inflammation are typical. The prognosis of the disease is good with spontaneous resolution being frequently observed, especially in localized forms. Disseminated manifestations tend to persist longer, and recurrences are reported. When choosing between different therapeutic options, the benign disease character versus the individual degree of suffering and the potential therapy side effects must be considered. For local treatment, topical application of corticosteroids is most common. Disseminated forms can be treated systemically with corticosteroids for several weeks; alternatively, dapsone, hydroxychloroquine, retinoids, fumaric acid, cyclosporine, and anti-TNFα appear to be effective.
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Herzinger T, Berneburg M, Ghoreschi K, Gollnick H, Hölzle E, Hönigsmann H, Lehmann P, Peters T, Röcken M, Scharffetter-Kochanek K, Schwarz T, Simon J, Tanew A, Weichenthal M. S1-Guidelines on UV phototherapy and photochemotherapy. J Dtsch Dermatol Ges 2016; 14:853-76. [DOI: 10.1111/ddg.12912] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Thomas Herzinger
- Department of Dermatology and Allergology; Ludwig Maximilians University; Munich Germany
| | - Mark Berneburg
- Department of Dermatology; University Medical Center; Regensburg Germany
| | | | - Harald Gollnick
- Department of Dermatology and Venereology; University Hospital; Otto von Guericke University; Magdeburg Germany
| | - Erhard Hölzle
- Department of Dermatology and Allergology; Medical Center Oldenburg; Oldenburg Germany
| | | | - Percy Lehmann
- Department of Dermatology; Allergology and Dermatosurgery; HELIOS-Medical Center; Wuppertal Germany
| | - Thorsten Peters
- Department of Dermatology and Allergology; University Medical Center; Ulm Germany
| | | | | | | | - Jan Simon
- Department of Dermatology; Venereology and Allergology; University Medical Center; Leipzig Germany
| | - Adrian Tanew
- Department of Dermatology; General Hospital of Vienna; Vienna Austria
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Cunningham L, Kirby B, Lally A, Collins P. The efficacy of PUVA and narrowband UVB phototherapy in the management of generalised granuloma annulare. J DERMATOL TREAT 2015; 27:136-9. [PMID: 26447167 DOI: 10.3109/09546634.2015.1087461] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Generalised granuloma annulare (GGA) is a significant cosmetic issue for patients but evidence is lacking to guide optimum treatment. We reviewed our patients with GGA treated with PUVA and narrowband UVB (NBUVB). A telephone questionnaire obtained the patients' perspective in terms of treatment response, remission and overall satisfaction. Twenty patients, all female, were treated. Twelve patients had 15 courses of PUVA therapy (10 oral, 5 bath PUVA) and 10 had 12 courses of NB UVB (two patients had both). There was clearance or minimal residual disease (MRD) on clinical examination in eight of 12 patients after PUVA. Remission was for six months in seven patients extending to one year or more in five patients. Nine patients were contactable after PUVA therapy. They reported their satisfaction as excellent (n = 1), very good (n = 2) or good (n = 4), and two were disappointed. There was clearance or MRD in seven patients treated with NBUVB. Remission was for six months in at least three patients and greater than 1 year in at least 2 patients. Eight patients were contactable and reported satisfaction as excellent (n = 1) or good (n = 5) and two were disappointed. PUVA and NBUVB were effective in at least half of patients and they achieved satisfactory remission. Patients' perceptions of the improvement after phototherapy were lower compared with their dermatologists' assessment.
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Affiliation(s)
- L Cunningham
- a Department of Dermatology , The Charles Centre, St. Vincent's University Hospital , Dublin , Ireland
| | - B Kirby
- a Department of Dermatology , The Charles Centre, St. Vincent's University Hospital , Dublin , Ireland
| | - A Lally
- a Department of Dermatology , The Charles Centre, St. Vincent's University Hospital , Dublin , Ireland
| | - P Collins
- a Department of Dermatology , The Charles Centre, St. Vincent's University Hospital , Dublin , Ireland
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Resolución de granuloma anular diseminado con fototerapia UVB de banda estrecha. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:240-1. [DOI: 10.1016/j.ad.2014.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 08/03/2014] [Accepted: 08/31/2014] [Indexed: 11/21/2022] Open
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Solano-López G, Concha-Garzón M, de Argila D, Daudén E. Successful Treatment of Disseminated Granuloma Annulare With Narrowband UV-B Phototherapy. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Lukács J, Schliemann S, Elsner P. Treatment of generalized granuloma annulare - a systematic review. J Eur Acad Dermatol Venereol 2015; 29:1467-80. [DOI: 10.1111/jdv.12976] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 12/19/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J. Lukács
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - S. Schliemann
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - P. Elsner
- Department of Dermatology; University Hospital Jena; Jena Germany
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Treatment regimens, protocols, dosage, and indications for UVA1 phototherapy: Facts and controversies. Clin Dermatol 2013; 31:438-454. [DOI: 10.1016/j.clindermatol.2013.01.011] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Poppe H, Poppe LM, Goebeler M, Trautmann A. Treatment of Disseminated Granuloma Annulare with Oral Vitamin E: Primum Nil Nocere'. Dermatology 2013; 227:83-8. [DOI: 10.1159/000353528] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 06/04/2013] [Indexed: 11/19/2022] Open
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Browne F, Turner D, Goulden V. Psoralen and ultraviolet A in the treatment of granuloma annulare. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2011; 27:81-4. [DOI: 10.1111/j.1600-0781.2011.00574.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Do T, Bailey E, Wang F, Smith N, Lee W, Fisher G, Voorhees J, Kang S. Targeted broadband ultraviolet B phototherapy improves disorders characterized by increased dermal matrix. Br J Dermatol 2009; 161:1405-7. [DOI: 10.1111/j.1365-2133.2009.09461.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Karsai S, Hammes S, Rütten A, Raulin C. Fractional photothermolysis for the treatment of granuloma annulare: A case report. Lasers Surg Med 2008; 40:319-22. [DOI: 10.1002/lsm.20640] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Rombold S, Lobisch K, Katzer K, Grazziotin TC, Ring J, Eberlein B. Efficacy of UVA1 phototherapy in 230 patients with various skin diseases. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2008; 24:19-23. [PMID: 18201353 DOI: 10.1111/j.1600-0781.2008.00328.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Investigation of the efficacy of ultraviolet (UV) A1 phototherapy on atopic eczema, scleroderma, granuloma annulare, urticaria pigmentosa, prurigo nodularis, lichen sclerosus et atrophicus, T-cell lymphoma, keratosis lichenoides chronica, chronic urticaria and some rare, sclerosing skin diseases. METHODS The data of 230 patients treated with low-dose, medium-dose and high-dose UVA1 therapy during 6 years were retrospectively analysed. The mean single dose (J/cm(2)), the mean number of irradiations and the mean total dose (J/cm(2)) were evaluated. The efficacy of phototherapy was assessed by a grading scale and the number of patients was given in percentage for each group. RESULTS Good therapeutic effects of UVA1 therapy were shown in patients with atopic eczema, scleroderma, lichen sclerosus et atrophicus, keratosis lichenoides chronica, prurigo nodularis and with cutaneous T-cell lymphoma. Positive effects in some patients were seen in the urticaria pigmentosa and granuloma annulare group, no change to slight improvement was seen in most of the patients with rare, sclerosing skin diseases and no effect was seen in the chronic urticaria group. CONCLUSION Besides topical and systemic therapy, UVA1 radiation is a good option of treatment in various skin diseases. It is one of the first-line treatments for several sclerotic diseases and it often improves pruritus considerably.
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Affiliation(s)
- S Rombold
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.
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Frigerio E, Franchi C, Garutti C, Spadino S, Altomare GF. Multiple localized granuloma annulare: ultraviolet A1 phototherapy. Clin Exp Dermatol 2007; 32:762-4. [PMID: 17725658 DOI: 10.1111/j.1365-2230.2007.02530.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Comte C, Picot E, Peyron JL, Dereure O, Guillot B. Les UVA-1 : propriétés et indications thérapeutiques. Ann Dermatol Venereol 2007; 134:407-15. [PMID: 17483769 DOI: 10.1016/s0151-9638(07)89204-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- C Comte
- Université Montpellier II, Service de Dermatologie, CHU Saint Eloi, Montpellier.
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Abstract
Granuloma annulare is a benign self-limiting disease of unknown origin, characterized by dermal papules tending to form annular shapes. It belongs to the granulomatous inflammatory skin diseases characterized by histomorphologically detectable granulomas. In addition to localized variants, generalized or disseminated variants also exist. The disease is often asymptomatic and does not require therapy in every case. Established therapies for localized forms of granuloma annulare are glucocorticosteroids, cream PUVA and cryosurgery. Antimalarials, antileprotics, retinoids, fumarates, UVA1 phototherapy and photochemotherapy are of value in disseminated cases. Recent case reports demonstrate the successful treatment of granuloma annulare with topical calcineurin antagonists or imiquimod and with the systemic administration of biologicals.
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Affiliation(s)
- L Kowalzick
- Klinik für Hautkrankheiten und Allergologie, HUMAINE-Vogtland-Klinikum Plauen GmbH.
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