Resolution of Refractory Generalized Granuloma Annulare After Treatment With Alitretinoin

A 72-year-old man with generalized granuloma annulare (GGA) unresponsive to multiple treatments achieved remission after 15 months of alitretinoin therapy. Partial remission was observed after 7 months, but switching to hydroxychloroquine led to exacerbation. Resuming alitretinoin resulted in complete flattening of lesions within 8 months. Alitretinoin, a pan-retinoid receptor agonist, demonstrated strong anti-inflammatory effects without significant side effects, suggesting its potential efficacy in treating refractory GGA, especially in elderly patients.