Disseminated granuloma annulare. Clinical experience in an adult patient

Abstract

Granuloma annulare is a benign, self-limited inflammatory dermatosis of unclear etiology characterized by nodular lesions that coalesce into annular plaques. Five clinical variants have been described, among which the disseminated form is uncommon. Disseminated granuloma annulare (DGA) is defined by the presence of more than 10 lesions with characteristic morphology distributed throughout the body.

Although its association with dyslipidemia has not been fully established, dyslipidemia remains the most frequently reported comorbidity. Associations with malignant neoplasms, medications, viral infections, vaccines, mesotherapy, botulinum toxin injections, and certain HLA subtypes have also been described.

Therapeutic options are varied and include intralesional corticosteroids, tetracyclines, systemic retinoids, vitamin E, dapsone, biologic agents, laser therapy, and Janus kinase (JAK) inhibitors. In addition, nutritional counseling plays an important role because of the potential metabolic associations of this condition.

We report a case of disseminated granuloma annulare in a male patient successfully treated with dapsone and minocycline after exclusion of other potential causes.