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The role of biologics in the treatment of chronic granuloma annulare
Author(s) -
Chen Alessandra,
Truong Allison K.,
Worswick Scott
Publication year - 2019
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.14350
Subject(s) - granuloma annulare , medicine , secukinumab , etanercept , dermatology , infliximab , adalimumab , golimumab , immunoglobulin d , ixekizumab , certolizumab pegol , granuloma , psoriasis , immunology , psoriatic arthritis , tumor necrosis factor alpha , b cell , antibody
Background Granuloma annulare ( GA ), a benign inflammatory skin disease, is considered a Th1‐type delayed hypersensitivity reaction. Localized GA is likely to resolve spontaneously, whereas disseminated GA ( DGA ) may persist for decades and can be resistant to treatment. Biologics including TNF ‐α inhibitors have been proposed and utilized as salvage therapy for GA and other related diseases, interstitial granulomatous dermatitis ( IGD ), and actinic granuloma ( AG ). Methods A systematic review was conducted using the combination of search terms “granuloma annulare,” “interstitial granulomatous dermatitis,” or “actinic granuloma” and either “biologics,” “etanercept,” “adalimumab,” “infliximab,” “ustekinumab,” “ixekizumab,” “secukinumab,” “guselkumab,” “golimumab,” “brodalumab,” “tildrakizumab,” or “certolizumab” from the years 1970–2017. Results Review of the literature revealed that 79.3% of the patients with GA , IGD , or AG who had been treated with demonstrated TNF ‐α inhibitor therapy a clinical response. Conclusions TNF ‐α inhibitor therapy has been used to treat chronic GA , IGD , and AG that involved extensive body surface areas. However, the literature is limited to case series lacking control groups. Randomized, controlled trials are required to establish evidence‐based treatment of GA and related cutaneous, granulomatous conditions.