Injection Therapy of Granuloma Annulare

Granuloma annulare, a disease of unknown etiology and somewhat capricious behavior, has been the subject of numerous therapeutic approaches. Local measures have included mercurial plaster, tincture of iodine, iodine ointment, sulfur and salicylic acid preparations, radiation, carbon dioxide snow, dichloro-tetrafluoro-ethane (Frigiderm), electrocoagulation, electrolysis, and radial incisions. Systemic treatment has included bismuth, gold sodium thiosulphate, arsenic, calciferol, glycerinated extract of sheep blood, sulfonamides, penicillin, and measles immune serum. Massive doses of vitamin E and pantothenic acid derivatives have been recommended by Welsh.¹He suggested that the metabolic products of vitamin E may be utilized in the formation of cortisone-like materials and that calcium pantothenate may act as a biological catalyst in this process. Traub²(in discussion of Welsh) raised the question as to whether the same results might be obtained by giving small injections of corticotropin. Carrying this reasoning one step further we wondered whether the injection of hydrocortisone