treatments for granuloma annulare

I have had granuloma annulare for about 20 years, confirmed by biopsy.  In recent years it has spread to both hands and both elbows and is less responsive to cortisone treatment and has reached a bothersome point..  I took a single 1500 mg dose of famiciclovir for fever blisters and got a rather dramatic, though temporary response.  A few months later when I took a second round I got a similar improvement.  It took 2-3 months after the first round for my lesions to get as bad as they had been prior to the antiviral.

Has anyone looked for a viral cause for GA or done any work on response to antivirals?  A quick Medline search showed little recent published research  

Thank you for any information you can give me.

[BhumikaMD]

Hi,

In severe cases of generalized granuloma annulare, your doctor may recommend a special kind of ultraviolet light therapy called psoralen plus ultraviolet A (PUVA). This treatment combines exposure to ultraviolet light (phototherapy) with drugs called psoralens, which help make your skin more receptive to the effects of ultraviolet light.

This therapy is given under the close supervision of  a dermatologist . The major side effect of PUVA is a sunburn-type reaction.

http://www.aad.org/public/publications/pamphlets/common_granuloma.html

Let us know about how you are doing and what your doctor advises.

Post us if you need any further information.

Regards.