David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Int J Dermatol. 2019 May;58(5):622-626. doi: 10.1111/ijd.14350. Epub 2019 Jan 7.
Granuloma annulare (GA), a benign inflammatory skin disease, is considered a Th1-type delayed hypersensitivity reaction. Localized GA is likely to resolve spontaneously, whereas disseminated GA (DGA) may persist for decades and can be resistant to treatment. Biologics including TNF-α inhibitors have been proposed and utilized as salvage therapy for GA and other related diseases, interstitial granulomatous dermatitis (IGD), and actinic granuloma (AG).
A systematic review was conducted using the combination of search terms "granuloma annulare," "interstitial granulomatous dermatitis," or "actinic granuloma" and either "biologics," "etanercept," "adalimumab," "infliximab," "ustekinumab," "ixekizumab," "secukinumab," "guselkumab," "golimumab," "brodalumab," "tildrakizumab," or "certolizumab" from the years 1970-2017.
Review of the literature revealed that 79.3% of the patients with GA, IGD, or AG who had been treated with demonstrated TNF-α inhibitor therapy a clinical response.
TNF-α inhibitor therapy has been used to treat chronic GA, IGD, and AG that involved extensive body surface areas. However, the literature is limited to case series lacking control groups. Randomized, controlled trials are required to establish evidence-based treatment of GA and related cutaneous, granulomatous conditions.
环状肉芽肿（GA）是一种良性炎症性皮肤病，被认为是 Th1 型迟发型超敏反应。局限性 GA 可能会自行消退，而播散性 GA（DGA）可能会持续数十年，并且可能对治疗有抵抗力。生物制剂，包括 TNF-α 抑制剂，已被提议并用于 GA 及其他相关疾病，如间质性肉芽肿性皮炎（IGD）和光化性肉芽肿（AG）的挽救治疗。
使用搜索词“环状肉芽肿”、“间质性肉芽肿性皮炎”或“光化性肉芽肿”与“生物制剂”、“依那西普”、“阿达木单抗”、“英夫利昔单抗”、“乌司奴单抗”、“依奇珠单抗”、“司库奇尤单抗”、“古塞库单抗”、“戈利木单抗”、“布罗达单抗”、“替利珠单抗”或“certolizumab”的组合进行了系统回顾，检索年限为 1970 年至 2017 年。
文献回顾显示，79.3%接受 TNF-α 抑制剂治疗的 GA、IGD 或 AG 患者出现了临床反应。
TNF-α 抑制剂疗法已被用于治疗广泛的皮肤表面受累的慢性 GA、IGD 和 AG。然而，文献仅限于缺乏对照组的病例系列。需要进行随机、对照试验，以确立 GA 和相关皮肤、肉芽肿性疾病的循证治疗方法。
