granulom annulare and high blood pressure medication

[Juniormay]

I have disseminated granuloma annulare that initially would show up on elbows and inner arms when I started first beta blockers, then calcium blockers for high blood pressure.  When I took lisinopril it become generalized. Stopping medication hasn't resulted in the rash disappearing.

Do these drugs cause a permanent immune impairment that would explain this ongoing granuloma?

JMAY

[Anniepie1999]

I have GA and my doctor wants to consider putting me on the malaria drug, Hydroxychloroquine or, Plaquenil.  Have you heard of this?  What is your opinion of this treatment.  

I am a fair-skinned blonde and the light treatment carries too high a cancer risk.  Cortesone creams do no good on me, and for having it for only about six months, I basically have it all over my body, including ears and eyelids.

Please comment, I'd be very interested in what you have to say.

Thanks, Anne

[Bhupinder Kaur, MD]

Hello,
The precise cause of granuloma annulare is unknown. Granuloma annulare has been hypothesized to be associated with tuberculosis, insect bites, trauma, sun exposure, thyroiditis, vaccinations, and viral infections, including HIV, Epstein-Barr virus, hepatitis B virus, hepatitis C virus, and herpes zoster virus. However medications like ACE inhibitors which are used as antihypertensives  can often trigger granuloma annulare. Lisiniopril is an ACE inhibitor.

Localized granuloma annulare (GA) is not often symptomatic and it has a tendency towards spontaneous resolution. We use isotretinoin or phototherapy with oral psoralen and UV-A (PUVA) as first-line options for generalized granuloma annulare. Please discuss these treatment options with your dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.