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VIGNETTES
Disseminated Granuloma Annulare Resolved With the T-Cell Modulator Efalizumab
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Granuloma annulare (GA) encompasses a benign group of granulomatous diseases that includes localized, disseminated (generalized), subcutaneous, and perforating types. Approximately 10% to 15% of patients have disseminated GA (DGA), which occurs primarily in adults and is characterized by multiple discrete or confluent papules with either an annular or a nonannular configuration.1
While the pathogenesis of GA remains unclear, evidence suggests a role for T-cell–mediated processes. Activated T lymphocytes, predominantly of the helper T-cell phenotype, have been identified as the dominant lymphocyte in GA infiltrates.2 Activated helper T cells secrete proinflammatory cytokines, including interleukins, gamma interferon, and tumor necrosis factor  ,3 all of which have been detected in GA lesions.2, 4 Gamma interferon–producing helper T cells may induce the differentiation of macrophages into an aggressive effector phenotype that contributes to the formation of GA lesions.2 Although the cause of the T-cell recruitment into the skin in GA is unknown, it has been . . . [Full Text of this Article] Report of a Case
Comment
Bernard S. Goffe, MD
Correspondence: Dr Goffe, Dermatology Associates, 1730 Minor Ave, Suite 1000, Seattle, WA 98101 (docgoffe@msn.com).
RELATED LETTER
Resolving Granuloma Annulare With Etanercept
Jerome Shupack and Kimberly Siu
Arch Dermatol. 2006;142(3):394-395.
EXTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Efalizumab in the Treatment of Discoid Lupus Erythematosus
Usmani and Goodfield
Arch Dermatol 2007;143:873-877.
ABSTRACT
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Resolving granuloma annulare with etanercept.
Shupack and Siu
Arch Dermatol 2006;142:394-395.
FULL TEXT
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