Looney Melissa, Smith Kelly M
College of Pharmacy, University of Kentucky, Lexington, 40536, USA.
Ann Pharmacother. 2004 Mar;38(3):494-7. doi: 10.1345/aph.1D312. Epub 2004 Jan 23.
To assess the utility and safety of isotretinoin in the treatment of granuloma annulare (GA).
Searches of MEDLINE (1966-January 2003), EMBASE (1989-January 2003), International Pharmaceutical Abstracts (1970-2002), and Allied and Complementary Medicine Database (1985-2002) were conducted. Key terms included granuloma annulare, isotretinoin, retinoids, and antioxidants.
Isotretinoin may have proliferative and inhibitory effects on collagen synthesis that improve GA symptoms. Cases reporting use of isotretinoin in the treatment of GA were reviewed. Several reports detail the successful use of isotretinoin 0.5-1 mg/kg/day, primarily in the disseminated form of the disease. However, some patients required dosage decreases in response to drug-related liver function test elevations, and 2 instances of drug failure were identified.
Isotretinoin should be reserved for patients with disseminated or refractory GA. Potential serious adverse effects associated with its use require careful monitoring.
评估异维A酸治疗环状肉芽肿（GA）的有效性和安全性。
检索了MEDLINE（1966年1月至2003年1月）、EMBASE（1989年1月至2003年1月）、国际药学文摘（1970年至2002年）以及补充与替代医学数据库（1985年至2002年）。关键词包括环状肉芽肿、异维A酸、维甲酸和抗氧化剂。
异维A酸可能对胶原蛋白合成具有增殖和抑制作用，从而改善GA症状。对报道使用异维A酸治疗GA的病例进行了回顾。多篇报告详细介绍了异维A酸0.5 - 1mg/kg/天的成功应用，主要用于播散型疾病。然而，一些患者因药物相关的肝功能检查升高而需要减少剂量，并且发现了2例治疗失败的情况。
异维A酸应仅用于播散型或难治性GA患者。其使用可能带来的严重不良反应需要仔细监测。
