title: Generalized annular granuloma associated with crowned dens syndrome, which resolved with colchicine treatment.
abstract: Granuloma annulare (GA) is a chronic, benign, and usually self-limiting cutaneous inflammatory disease, typically characterized by small, localized, skin-coloured papules that are usually asymptomatic or mildly pruriginous. Its aetiopathogenesis is still unknown and treatments are rarely effective. Generally, 50-70% of localized GA cases are self-limiting and show spontaneous resolution after 1-2 years, whereas disseminated GA is less likely to disappear without treatment. Treatment of generalized GA is usually based on single case reports, and only a few studies involving large case series have been published. We present the case of a patient affected by generalized GA, which resolved after colchicine treatment used for concomitant crowned dens syndrome due to calcium pyrophosphate deposition disease (CPPD). Colchicine may have worked by a direct action on GA or, alternatively, by controlling CPPD, as a possible trigger. As the low-dosage colchicine treatment was well tolerated by our patient, this could be easily used in the management of GA. However, further studies are needed to confirm the action of colchicine on GA.
authors.affiliation: IRCCS, AOU. San Martino-IST, Di.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Cozzani
authors.affiliation: IRCCS, AOU. San Martino-IST, Di.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Basso
authors.affiliation: Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Cimmino
authors.affiliation: Department of Medicine-DIMED, Division of Rheumatology, University of Padua, Padua, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Larosa
authors.affiliation: IRCCS, AOU. San Martino-IST, Di.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Burlando
authors.affiliation: IRCCS, AOU. San Martino-IST, Di.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rongioletti
authors.affiliation: IRCCS, AOU. San Martino-IST, Di.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Drago
authors.affiliation: IRCCS, AOU. San Martino-IST, Di.S.Sal. Section of Dermatology, University of Genoa, Genoa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Parodi
mesh_terms: D002805:Chondrocalcinosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003078:Colchicine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006074:Gout Suppressants / Q000627:therapeutic use; D006099:Granuloma; D016460:Granuloma Annulare / Q000150:complications / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D019547:Neck Pain / Q000000981:diagnostic imaging*; D012871:Skin Diseases / Q000473:pathology; D013582:Synovial Fluid / Q000737:chemistry; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D006074:Gout Suppressants; D003078:Colchicine