26611 Apremilast in the management of generalized granuloma annulare: A case series

Abstract

This case series evaluates four female patients of ages 29, 61, 66, and 73 years old with a history of recalcitrant generalized granuloma annulare (GA) treated with oral apremilast. All four had previously failed numerous therapies for GA including topical and intralesional steroids, hydroxychloroquine, and narrowband ultraviolet B light phototherapy. Generalized granuloma annulare is a difficult disease to treat and can lead to anxiety and frustration for both patients and providers. The etiopathogenesis of GA is unknown, and as such the disease has few treatments that have been thoroughly studied or consistently effective. This case series illustrates a novel therapy, apremilast, a phosphodiesterase-4 inhibitor, in the treatment of four patients with generalized GA resulting in improvement of their skin disease. The possible etiopathogenesis of GA, as well as the mechanism behind the efficacy of apremilast in treating GA, are both explored. However, larger, controlled trials of apremilast in patients with GA are needed to further evaluate the efficacy of apremilast in the treatment in GA.