[Retinoids in therapy of granuloma anulare disseminatum]

We report on four patients with granuloma annulare disseminatum successfully treated with etretinate as basic medication. In two cases there was complete remission after treatment with initial doses of up to 0.9 mg/kg body weight etretinate. One patient did not respond to etretinate alone but the condition was cured when Re-PUVA therapy was administered in addition. In another patient, with widespread granuloma annulare, primary treatment with Re-PUVA was instigated, followed by low-dose monotherapy with etretinate. According to these findings, we propose a three-stage regimen of therapy. After checking that the indications are appropriate, we first initiate monotherapy with etretinate and switch to a low-dose treatment over a longer period on response. If there is no response we switch to the second stage, i.e. Re-PUVA therapy; the third is then etretinate monotherapy to prevent relapse.