title: Treatment of disseminated granuloma annulare with low-dose fumaric acid.
abstract: While localized variants of granuloma annulare are typically self-limited, disseminated granuloma annulare tends to be chronic and often therapy-resistant. Treatment with fumaric acid esters is effective for severe forms of psoriasis. Disseminated granuloma annulare has also been reported to respond to fumaric acid esters. We treated 8 patients (mean age 64.2 years; 4 men, 4 women) with low-dose fumaric acid esters for 1-18 months. One patient showed complete clearance, 4 marked improvement, one slight to moderate improvement and one no response. One patient discontinued treatment due to nausea after one month and another stopped it after 18 months. Five out of 8 patients tolerated the treatment well. Six patients developed transient, mild leucopaenia and one eosinophilia. None of these blood abnormalities necessitated discontinuation of therapy. Low-dose fumaric acid esters significantly improve disseminated granuloma annulare in approximately 63% of patients. Larger, controlled, prospective studies are needed to evaluate its efficacy and safety in this setting.
authors.affiliation: Department of Dermatology, Eberhard-Karls-University, Munich, Germany.
authors.forename: H Oliver
authors.initials: HO
authors.lastname: Weber
authors.forename: Claudia
authors.initials: C
authors.lastname: Borelli
authors.forename: Martin
authors.initials: M
authors.lastname: Röcken
authors.forename: Martin
authors.initials: M
authors.lastname: Schaller
mesh_terms: D000284:Administration, Oral; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000069462:Dimethyl Fumarate; D005260:Female; D005650:Fumarates / Q000008:administration & dosage / Q000627:therapeutic use*; D016460:Granuloma Annulare / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D005650:Fumarates; D000069462:Dimethyl Fumarate