How do you approach treating disseminated granuloma annulare?
Do you order blood work to evaluate for underlying dyslipidemia or other metabolic diseases?
Answer from: at Academic Institution
I have not found disseminated GA associated with diabetes in my clinical experience even though it has been reported in the literature. Similarly, disseminated GA has been reported with SLE in the literature and I have seen that once in my experience. I would only check for diabetes or SLE if there ...
In my experience, TNF alpha inhibitors are the only therapeutic intervention with a high success rate. The response rate is extremely high, at least 75%. However, coverage is challenging and the issue virtually always recurs on discontinuation. Jak inhibitors might be beneficial as above, but SE pro...
Dr. @Braverman was one of my first mentors in dermatology. He remains one of the brightest and most thoughtful dermatologists that I have ever known. Luckily, he continues to be a regular and insightful contributor to Yale Grand Rounds. His suggestion of niacin-amide is an excellent one.
Generalize...
I do not routinely screen for DM or lipid disorder, but I do talk to patients about the association and encourage discussion with their PCP for screening if indicated and not yet done.
Regarding treatment, I talk about the many options with my patients and let them choose. But in general, I guide t...
Where I trained, we had decent success with HCQ + phototherapy or combined with doxy and pentoxyphylline. In recalcitrant cases, we used Humira with excellent results. But now, I’ve been blown away by those I’ve tried Upadacitinib on, it’s just melted their GA away. I know Abrociti...