Apremilast in the Management of Generalized Granuloma Annulare: A Case Series

Background: Granuloma annulare is a difficult disease to treat and can lead anxiety frustration for both patients providers. The pathogenesis of granuloma unknown, resulting in few thoroughly studied or consistently effective treatments.
 Objective: 1) To discuss whether treatment with apremilast could improvement resolution generalized annulare. 2) explore the possible mechanism treating this disease.
 Methods: A case series was used study clinical response 6 history recalcitrant taking 30mg twice daily.
 Results: Two achieved complete clearance their without recurrence while remaining 4 significant lesion number, induration, erythema.
 Limitations: This small larger, controlled trials long-term follow-up are needed. There no objective method evaluating extent Furthermore, our concomitant topical intralesional steroids on apremilast.
 Conclusion: illustrates novel therapy, apremilast, phosphodiesterase-4 inhibitor, explores mechanisms behind success treatment.