title: Photodynamic therapy for granuloma annulare: more than a shot in the dark.
abstract: BACKGROUND
  Granuloma annulare (GA) is a benign granulomatous and inflammatory skin disorder. The pathogenesis remains enigmatic and convincingly effective treatment options are not available. Inspired by a report showing photodynamic therapy (PDT) to be effective in a single patient with GA, we sought to evaluate this benefit in a series of patients with GA.
  
  
  METHODS
  PDT was performed in 7 consecutive patients with histologically confirmed GA located at the extremities. First, 20% ALA gel was applied under an occlusive dressing for 5 h, followed by illumination with 100 J/cm(2) by a standard red-light source. In total, 2-3 PDT sessions were performed, with an interval of 2-4 weeks between each session. Treatment was stopped when complete remission was achieved or when GA lesions remained unchanged after 2 consecutive PDT sessions. The overall response rate was 57%. In 2 patients (29%), GA cleared completely, in 2 patients (29%) the skin lesions improved markedly and in 3 patients (43%) no clinical response could be observed.
  
  
  CONCLUSIONS
  These promising results should be evaluated in larger controlled studies. In selected patients, PDT might be a valuable recruit for the sparse armory available to treat GA.
authors.affiliation: Department of Dermatology, Ludwig Maximilian University, Munich, Germany. peter.weisenseel@med.uni-muenchen.de
authors.forename: Peter
authors.initials: P
authors.lastname: Weisenseel
authors.forename: Alexander Vasilevic
authors.initials: AV
authors.lastname: Kuznetsov
authors.forename: Sonja
authors.initials: S
authors.lastname: Molin
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Carola
authors.initials: C
authors.lastname: Berking
authors.forename: Joerg Christoph
authors.initials: JC
authors.lastname: Prinz
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D004550:Elbow; D005260:Female; D016460:Granuloma Annulare / Q000188:drug therapy* / Q000473:pathology; D006225:Hand; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid