Granuloma annulare treated with excimer laser

Abstract

Objective: To review the current therapy for granuloma annulare and report a case of refractory generalized granuloma annulare successfully treated with excimer laser. A discussion about the characteristics of excimer laser and the mechanism of its effectiveness is presented.

Design: Patient case report and literature review.

Setting: Outpatient dermatology practice.

Participants: A 73-year-old woman suffering from generalized granuloma annulare for more than 40 years.

Measurements: Change in clinical appearance of lesions.

Results: Use of excimer laser therapy resulted in prompt and complete resolution in treated areas with no residual skin changes or side effects.

Conclusion: Excimer laser therapy is a powerful treatment modality with minimal side effects for patients with granuloma annulare. Further study is necessary to elucidate optimal dosing, long-term efficacy, and safety profile.

Figure 1

Dorsum of patient’s right hand showing serpiginous erythematous plaques consistent with granuloma annulare. The patient had similar lesions on her trunk and extremities, but not her face.

Figure 2

Cellular infiltration present in reticular dermis

Figure 3

Interstitial proliferation of histiocytes and multinucleated cells surrounding zones of altered collagen and mucin. A perivascular lymphocytic infiltrate is observed as well.

Figure 4

Dorsum of patient’s hand after treatment with excimer laser, showing complete resolution of granuloma annulare with no residual skin changes.