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Assessment of Treatment of Refractory Granuloma Faciale With Intralesional Rituximab.

Abstract：

Importance:Granuloma faciale (GF) is a rare, benign inflammatory dermatosis of unknown cause. Some reports have suggested that it could be part of the spectrum of IgG4-related sclerosing diseases. Granuloma faciale is characterized by single or multiple red-brown nodules, most frequently occurring on the face, and it can produce severe disfigurement. Treatment is difficult, and poor outcomes are often seen. Rituximab is a monoclonal antibody against CD-20 approved by the US Food and Drug Administration for treatment of some autoimmune and tumoral diseases. Objective:To evaluate the treatment of refractory GF with intralesional rituximab. Design, Setting, and Participants:In this case series, 3 patients with biopsy-proved refractory GF who underwent treatment at a dermatology outpatient clinic of a tertiary referral hospital were evaluated. The study was conducted from August 2015 to December 2017. Interventions:Doses of 0.5 to 1 mL/cm2 of intralesional rituximab, 10 mg/mL, were administered monthly for 6 months and thereafter depending on clinical response. In 2 patients, peripheral blood B-cell counts were monitored before and during treatment, and in 1 patient, only during treatment. Main Outcomes and Measures:Reduction in size of the lesions, ultrasonography evaluation, subjective improvement, and adverse events were monitored throughout the course of therapy. Results:All 3 of the patients were men (ages from 30s to 60s). They showed a significant reduction in the size and thickness of GF both clinically and on ultrasonography evaluation. Two patients had a complete response and the third, a partial response. A reduction in peripheral blood B-cell count was observed in the 3 patients, suggesting that the action of rituximab could be systemic. No severe adverse reactions were reported. Conclusions and Relevance:Intralesional rituximab may represent a novel and well-tolerated therapy for refractory GF.

journal_name

JAMA Dermatol

journal_title

JAMA dermatology

authors

Morgado-Carrasco D,Giavedoni P,Mascaró JM Jr,Iranzo P

doi

10.1001/jamadermatol.2018.2681

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

1312-1315

issue

eissn

2168-6068

issn

2168-6084

pii

2698663

journal_volume

154

pub_type

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Assessment of Treatment of Refractory Granuloma Faciale With Intralesional Rituximab.