From the Research
Interstitial granuloma annulare is a benign, self-limiting skin condition that can be effectively managed with high-potency topical corticosteroids, such as clobetasol 0.05% applied twice daily for 2-4 weeks to affected areas. The condition is characterized by small papules arranged in rings or semicircles with histological features showing interstitial infiltration of histiocytes between collagen bundles 1.
Treatment Options
- High-potency topical corticosteroids, such as clobetasol 0.05% applied twice daily for 2-4 weeks to affected areas
- Intralesional corticosteroid injections using triamcinolone acetonide (5-10 mg/ml) may be administered directly into lesions every 3-4 weeks for resistant cases
- Phototherapy, particularly PUVA or narrowband UVB, can be effective for widespread lesions with sessions 2-3 times weekly for 8-12 weeks
- Systemic treatments for severe or recalcitrant cases include hydroxychloroquine (200-400 mg daily), dapsone (50-150 mg daily), or isotretinoin (0.5-1 mg/kg/day) 2
Pathophysiology and Associations
The pathophysiology involves delayed-type hypersensitivity reaction with degradation of collagen, though the exact trigger remains unclear 3. Patients should be monitored for diabetes mellitus as there is an association between the conditions, and sun protection is recommended as UV exposure may worsen lesions in some patients 4.
Prognosis
The condition often resolves spontaneously within 2 years, though recurrence is common 5. The localized variant generally self-resolves within 2 years without treatment, whereas the generalized form is more chronic and less responsive to treatment 2.