Department of Dermatology, University Hospital Jena, Jena, Germany.
J Eur Acad Dermatol Venereol. 2015 Aug;29(8):1467-80. doi: 10.1111/jdv.12976. Epub 2015 Feb 4.
Granuloma annulare (GA) is a benign inflammatory skin disease. Localized GA is likely to resolve spontaneously, while generalized GA (GGA) is rare and may persist for decades. GGA usually is resistant to a variety of therapeutic modalities and takes a chronic course. The objective of this study was to summarize all reported treatments of generalized granuloma annulare. This is a systematic review based on MEDLINE, Embase and Cochrane Central Register search of articles in English and German and a manual search, between 1980 and 2013, to summarize the treatment of generalized granuloma annulare. Most medical literature on treatment of GGA is limited to individual case reports and small series of patients treated without a control group. Randomized controlled clinical studies are missing. Multiple treatment modalities for GGA were reported including topical and systemic steroids, PUVA, isotretinoin, dapsone, pentoxifylline, hydroxychloroquine, cyclosporine, IFN-γ, potassium iodide, nicotinamide, niacinamide, salicylic acid, dipyridamole, PDT, fumaric acid ester, etanercept, infliximab, adalimumab. While there are numerous case reports of successful treatments in the literature including surgical, medical and phototherapy options, well-designed, randomized, controlled clinical trials are required for an evidence-based treatment of GGA.
环状肉芽肿（GA）是一种良性炎症性皮肤病。局限性 GA 可能会自行消退，而全身性 GA（GGA）则较为罕见，可能会持续数十年。GGA 通常对多种治疗方法均有抵抗力，呈慢性病程。本研究的目的是总结所有已报道的全身性环状肉芽肿的治疗方法。这是一项系统综述，基于 1980 年至 2013 年 MEDLINE、Embase 和 Cochrane 中央登记处检索英文和德文文献，以及手动检索，总结了全身性环状肉芽肿的治疗方法。大多数关于 GGA 治疗的医学文献仅限于个体病例报告和未经对照组治疗的小系列患者。目前缺乏随机对照临床试验。报道了多种治疗 GGA 的方法，包括局部和全身类固醇、PUVA、异维 A 酸、氨苯砜、己酮可可碱、羟氯喹、环孢素、IFN-γ、碘化钾、烟酰胺、烟酸、水杨酸、双嘧达莫、PDT、富马酸酯、依那西普、英夫利昔单抗、阿达木单抗。尽管文献中有许多成功治疗的病例报告，包括手术、药物和光疗方法，但需要设计良好、随机、对照的临床试验来为 GGA 的治疗提供循证依据。
