Treatment of granuloma annulare and related granulomatous diseases with sulphasalazine: a series of 16 cases

Background Granuloma annulare (GA) and the related annular elastolytic giant cell granuloma (AEGCG) and interstitial granulomatous dermatitis (IGD) are idiopathic histiocytic inflammatory disorders, which are frequently recalcitrant to treatment. Objectives Evaluate the efficacy of sulphasalazine in treating GA, AEGCG and IGD. Methods Sixteen patients were identified with granulomatous disease who were treated with sulphasalazine between September 2015 and September 2019. Outcomes were based on patients’ and providers’ subjective evaluations. Results Sixteen patients were included in the study (ages 56–89, four male and twelve female). Previous treatments were attempted in fifteen patients. Clinical improvement was seen in fourteen patients (87.5%). Initial improvement was noted within a mean (SD) of 66.4 (35.1) days after starting therapy, with increasing benefits over time. Ten patients (62.5%) reported complete or near‐complete clearance, three patients (18.8%) reported significant improvement, and one (6.3%) reported partial improvement. Twelve patients elected to stop or reduce therapy, resulting in relapse or worsening in five patients. Conclusions Sulphasalazine may be considered as treatment for GA and GA‐related conditions.