Generalized Granuloma Annulare: A Therapeutic Challenge. Our Experience in 12 Patients

The document reports on a retrospective study of 12 patients with generalized granuloma annulare, a benign skin disease characterized by umbilicated papules or annular plaques. The study, conducted at Gregorio Marañón Hospital in Madrid, Spain, between January 1, 2007, and February 28, 2010, included 11 adults aged between 22 and 65, and one 10-year-old boy, with a higher prevalence in women (10 out of 12 patients). None of the patients had associated systemic or malignant diseases. The duration of the lesions at the first clinical visit ranged from 3 months to 30 years, with the lower extremities being the most affected location. All patients underwent skin biopsies, which confirmed granuloma annulare, predominantly with an interstitial pattern. The most effective treatment among those prescribed was phototherapy with oral psoralen plus ultraviolet A light (PUVA), which improved lesions in five patients, although four experienced relapses after treatment. Two cases showed spontaneous remission. The study concluded that the course of generalized granuloma annulare is often chronic and unpredictable, with spontaneous remission being rare and PUVA being the most effective treatment, despite the high recurrence rate post-treatment.