Assessing the Effect of Adalimumab in Granuloma Annulare: A Case Series and Literature Review

ABSTRACT Granuloma annulare (GA) is a benign granulomatous skin disorder for which standardized treatment guidelines are lacking due to limited evidence. Adalimumab, a TNF‐α inhibitor, shows promise as a therapeutic option due to its potential to disrupt GA granulomas. This 10‐year retrospective case series, conducted at Aarhus University Hospital, identified GA patients treated with adalimumab. Baseline characteristics, comorbidities, prior treatments, and responses to adalimumab were documented. Six patients were included in the study. Three patients, with a mean treatment duration of 46 months, achieved complete remission. Two patients, with a mean treatment duration of 11.5 months, experienced full symptom remission but skin lesions remained unchanged. One patient prematurely discontinued treatment due to adalimumab‐induced palmoplantar pustulosis. Adalimumab shows promising potential in the treatment of GA with continuous use for over 12 months, leading to complete remission in some cases. The observed divergence between symptom improvement and skin lesion resolution suggests a gradual skin clearance process, highlighting the importance of sustained long‐term therapy.