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Have there been reports of granuloma annular following ingestion of allopurinol?
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- Yes. Granuloma annular has been reported to follow ingestion of allopurinol. It has also been reported to follow insects bites, sun exposure, tuberculin skin tests, trauma, and viral infections (including, Epstein-Barr, HIV hepatitis C, and herpes zoster). It remains unknown exactly how and why granuloma annular is triggered. Whatever the cause, it is clear that the condition causes our body’s immune system to react, resulting in inflammation.[1]
- Last Reviewed: 1/7/2009
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I have disseminated granuloma annular. Will this condition cause my tissue to die? (Back to Top)
- On a cell and tissue level, it is suspected that in granuloma annular, inflammation surrounds blood vessels and changes collagen and elastic tissues.[1] These changes cause the characteristic skin lesions. As the condition progresses the skin lesions may slowly increase in size, however with time many cases of granuloma annular spontaneously resolve.[1] As a result the condition is often considered to be a benign, self-limiting condition, and usually does not cause any symptoms other than mild itching. However, for some it it can take many years for disseminated lesions to resolve, in other cases the granuloma annular never fully resolves, and these lesions can recur.[1]
- Last Reviewed: 1/7/2009
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How might granuloma annulare be treated? (Back to Top)
- Granuloma annulare is difficult to treat and there are a limited number of clinical trials to reliably inform patients and physicians of the treatment options. Fortunately, most lesions of granuloma annulare disappear with no treatment within two years. Sometimes, however, the rings can remain for many years.[3] Very strong topical steroid creams or ointments may be used to speed the disappearance of the lesions. Injections of steroids directly into the rings may also be effective. Some physicians may choose to freeze the lesions with liquid nitrogen. In severe cases, ultraviolet light therapy (PUVA) or oral medications may be needed.[2]
Other treatments that have been tried include [3][1]:
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Dapsone (a type of antibiotic) for widespread granuloma annulare
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Etretinate (not available in the US)
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Chloroquine
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Cyclosporine
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Niacinamide
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Oral psoralen
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Vitamin E combined with a 5-lipoxygenase inhibitor
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Fumaric acid esters
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Topical tacrolimus
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Pimecrolimus
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Infliximab (in a patient with disseminated granuloma annulare that did not respond to other treatments)
A review article titled, 'Diagnosis and Management of Granuloma Annulare' provides additional information on treatment options for granuloma annulare: http://www.aafp.org/afp/20061115/1729.html
Also, an article from eMedicine Journal provides information on treatment for granuloma annulare at the following link. You may need to register to view the article, but registration is free.
http://www.emedicine.com/derm/topic169.htm
- Last Reviewed: 9/23/2008
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Are there any clinical trials investigating new treatments for granuloma annulare? (Back to Top)
- Yes. The U.S. National Institutes of Health, through the National Library of Medicine, developed ClinicalTrials.gov to provide patients, family members, and members of the public with current information on clinical research studies. Currently, 1 clinical trial is enrolling individuals with granuloma annulare, 'Ultraviolet B (UVB) Light Therapy in the Treatment of Skin Conditions With Altered Dermal Matrix.' Review the study's eligibility criteria to determine its appropriateness. Use the study’s contact information to learn more.
In addition, there is a study, entitled 'Evaluation and Treatment of Patients Who Have Skin Diseases' which may be of interest to you. Patients enrolled in this protocol will be evaluated and treated according to generally available, standard procedures, and therapeutic modalities. Samples of blood and skin will be studied by routine and specialized investigative methods to establish these patients' diagnosis, response to treatment, and/or disease progression. To view information about this clinical trial, click on the link above and review its eligibility criteria to determine its appropriateness.
You can also contact the Patient Recruitment and Public Liaison Office at the National Institutes of Health (NIH). We recommend calling the toll-free number listed below to speak with a specialist, who can help you determine if there are any other trials which would be appropriate for an individual with granuloma annulare.
Patient Recruitment and Public Liaison Office
NIH Clinical Center
Bethesda, Maryland 20892-2655
Toll-free: 800-411-1222
Fax: 301-480-9793
Email: prpl@mail.cc.nih.gov
Web site: "http://clinicalcenter.nih.gov/
- Last Reviewed: 9/23/2008