Kossard S, Winkelmann R K
Arch Dermatol. 1978 Feb;114(2):216-20.
The conditions of three patients who had generalized granuloma annulare responded favorably to treatment with alkylating agents. This mode of therapy in two cases was chosen on the basis of recent evidence that implicates delayed hypersensitivity mechanisms as forming part of the pathogenesis of granuloma annulare. Two patients had rapid clearing of their lesions. The response in one of these patients was observed during therapy for a concomitant plasma cell dyscrasia. The third patient had an unusual form of granuloma annulare that had evolved during a period of 28 years, with hand deformities secondary to fascial and tendon involvement and the production of contractures and lymphedema, which responded partially to therapy. The results lend further support to data implicating cellular immunity to granuloma annulare.
三名泛发性环状肉芽肿患者的病情对烷化剂治疗反应良好。在两例中选择这种治疗方式是基于最近的证据，该证据表明迟发型超敏反应机制是环状肉芽肿发病机制的一部分。两名患者的皮损迅速消退。其中一名患者在治疗同时存在的浆细胞异常增生症期间观察到了反应。第三名患者患有一种不寻常形式的环状肉芽肿，病程长达28年，因筋膜和肌腱受累出现手部畸形，并产生挛缩和淋巴水肿，对治疗有部分反应。这些结果进一步支持了涉及对环状肉芽肿细胞免疫的数据。
