Severe Generalized Granuloma Annulare

I have had generalized granuloma annulare for the past 20 years, it continues to spread and no lesions ever heal. It affects almost every part of my body. In the past two months it has escalated exponentially, the frequency of new lesions and the spread of already present ones have taken months in what in the past would have taken years. The skin discoloration has also become much more severe as well as the inflammation of the papules. I have had two biopsies done to confirm the diagnosis of GA, we have tried topical steroids, sub-dermal steroid injections, PUVA light therapy, and dapsone, all of which have had no effect on the resolution of present lesions or preventing the spread of the condition. I have seen multiple dermatologists. I have posted pictures on my profile. I also have other conditions that may be considered co-morbid with the GA, to explain in very short words- Fibromyalgia and Chronic Fatigue Syndrome, Hashimoto's Disease, Reynaud's Syndrome, Hypermobility Syndrome among numerous other disorders. I have had no concrete all encompassing diagnosis, for more details please see my profile or message me. I am desperately searching for alternative GA treatments, and am looking for any ideas or suggestions.

[maatson]

If I were looking at the photographs without history, my clinical impression would be Tinea corporis (Tinea incognito). I wonder whether this is at all related to your original diagnosis. I would do a scraping for fungus and  then proceed.
Regards and best wishes.

[maatson]

I had a re look again and looking at the central clearance and peripheral extending borders, gives a fairly clear diagnosis Tinea corporis.
Cheers!

[EmilyC88]

It is not ringworm, my dermatologists have tested for that. I have had both a punch biopsy and an incisional biopsy done on different areas of my body that are affected and both confirmed granuloma annulare.

[maatson]

As I told you I would have thought of T.corporis with only the photo minus history.
While agreeing with the earlier diagnosis,generally granuloma annulare  lesions are indolent and slow in evolution.
My thought here was, can not a patient with GA have tinea growing now? If there are no new lesions and it is the only old ones that are growing I would say it is only GA.
It is prudent therefore to have another look at it.
My good wishes.

[maatson]

Response of Generalized Granuloma Annulare to High-Dose Niacinamide
Alice Ma, MD; Maria Medenica, MD
Arch Dermatol. 1983;119(10):836-839. doi:10.1001/archderm.1983.01650340046018
.
While now they use biologicals in GA which have side effects, herewith giving you a relatively safe therapy tried years back.

Do consult your physician before any treatment.ok?
Best wishes.