Photodynamic therapy for granuloma annulare: more than a shot in the dark

Dermatology. 2008;217(4):329-32. doi: 10.1159/000155643. Epub 2008 Sep 18.

Abstract

Background: Granuloma annulare (GA) is a benign granulomatous and inflammatory skin disorder. The pathogenesis remains enigmatic and convincingly effective treatment options are not available. Inspired by a report showing photodynamic therapy (PDT) to be effective in a single patient with GA, we sought to evaluate this benefit in a series of patients with GA.

Observations: PDT was performed in 7 consecutive patients with histologically confirmed GA located at the extremities. First, 20% ALA gel was applied under an occlusive dressing for 5 h, followed by illumination with 100 J/cm(2) by a standard red-light source. In total, 2-3 PDT sessions were performed, with an interval of 2-4 weeks between each session. Treatment was stopped when complete remission was achieved or when GA lesions remained unchanged after 2 consecutive PDT sessions. The overall response rate was 57%. In 2 patients (29%), GA cleared completely, in 2 patients (29%) the skin lesions improved markedly and in 3 patients (43%) no clinical response could be observed.

Conclusion: These promising results should be evaluated in larger controlled studies. In selected patients, PDT might be a valuable recruit for the sparse armory available to treat GA.

MeSH terms

  • Administration, Cutaneous
  • Aged
  • Aminolevulinic Acid / administration & dosage*
  • Elbow*
  • Female
  • Granuloma Annulare / drug therapy*
  • Granuloma Annulare / pathology
  • Hand*
  • Humans
  • Leg*
  • Male
  • Middle Aged
  • Photochemotherapy / methods*
  • Photosensitizing Agents / administration & dosage*
  • Treatment Outcome

Substances

  • Photosensitizing Agents
  • Aminolevulinic Acid