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Stefan Schanz, MD; Marc Schmalzing, MD; Emmanuella Guenova, MD; Gisela Metzler, MD; Anja Ulmer, MD; Ina Kötter, MD; Gerhard Fierlbeck, MD

Arch Dermatol. 2012;148(1):17-20. doi:10.1001/archdermatol.2011.341

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 68-year-old man was referred with interstitial granulomatous dermatitis with arthritis involving a large area of his skin. Different treatment approaches remained unsuccessful. Finally, we initiated a treatment with tocilizumab. The response was promising.

REPORT OF A CASE

A 68-year-old man presented with disseminated erythematous and flesh-colored, linearly arranged papules on the upper and lower extremities and the trunk (Figure 1). In contrast to granuloma anulare, severe generalized pruritus and pain characterized his lesions. Associated symptoms included severe symmetrical pain at his shoulders, hips, thighs, finger joints, and hands with morning stiffness. He also reported night sweats, recurring fever, and weight loss of 7 kg. His medical history revealed chronic kidney disease stage IV, coronary heart disease, and 2 completely excised basal cell carcinomas.

Figure appears in full text version. Figure 1. Disseminated and confluent cutaneous erythematous . . . [Full Text of this Article]

THERAPEUTIC CHALLENGE

SOLUTION

COMMENT

AUTHOR INFORMATION
Departments of Dermatology (Drs Schanz, Guenova, Metzler, Ulmer, and Fierlbeck) and Internal Medicine II (Dr Schmalzing) and Interdisciplinary Center for Rheumatology, Immunology, and Autoimmune Diseases (Drs Schanz, Schmalzing, Guenova, Kötter, and Fierlbeck), University of Tuebingen, Tuebingen, Germany

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