Study reports on the incidence in the United States, prevalence of granuloma annulare

A new cross-sectional study has detailed the prevalence of granuloma annulus in the United States, providing insight into its epidemiology and incidence.

Few large-scale population-based studies have explored the prevalence and incidence of the rare disease, and the burden of it has not been well established.

As such, a team led by John Barbieri, MD, MBA, of the Perelman School of Medicine, University of Pennsylvania, used the ICD-10 codes to assess patient data from the Optum Clinformatics database between January 1, 2017 and December 31, 2018.

“Optum Clinformatics Data Mart includes anonymized commercial claims data for approximately 18-20 million covered people in the United States each year,” they noted.

The study

The team collected demographic and clinical data from 11,608 patients with incident granuloma annulus as well as 17,862 patients with prevalent granuloma annulus. Of those with the incidental illness, 74.8% were female and the average age was 56.5 years.

Of those with prevalent granuloma annulus, 75.8% were female and the mean age was 56.6 years.

Thus, the overall annualized incidence was 0.04%, or 37.9 per 100,000 (95% CI, 36.9-38.9) person-years. The overall annualized prevalence was 0.06%, or 58.3 per 100,000 (95% CI, 57.1-59.5) person-years.

Barbieri and colleagues noted that the overall incidence of granuloma annulare was higher in women (female-to-male ratio, 2.8: 1; P<.001 and in those the decade of life.>

The incidence among 50-59 year olds was 58.6 per 100,000 (95% CI, 55.2-62.0) person-years, compared with 34.6 per 100,000 (95% CI, 31, 9-37.2) person-years among 40-49 year olds. and 23.1 per 100,000 person-years (95% CI, 21.0-25.3) for those aged 30-39 (P <.001>

In addition, the incidence was higher in white patients (48.2 [95% CI, 46.8- 49.7]) than black patients (21.3 [95% CI, 18.8-23.9]; P

Investigators also reported that the prevalence of granuloma annulare was also higher in women (female-to-male ratio, 3.0: 1; P<.001>

Similar to incident disease, the prevalence was highest in people in the fifth decade of life (91.5 per 100,000 [95% CI, 87.3-95.8] person-years) and white individuals (72.7 [95% CI, 70.9-74.4]).

“Within 6 months of their first diagnosis, 4822 patients (41.5%) filled a prescription for a topical corticosteroid, and 1087 patients (9.4%) received an intralesional injection,” they wrote. “Within 6 months of their first diagnosis, oral tetracycline class antibiotic prescriptions were filled by 820 patients (7.1%) and hydroxychloroquine prescriptions were filled by 268 patients (2, 3%). ”

Frequencies of treatment use were similar at month 12, investigators noted. Phototherapy, dapsone, systemic retinoids, and TNF inhibitors were rarely used as therapies.

Patients also rarely presented to the clinician other inflammatory skin disorders, such as acne (2.4%), psoriasis (1.2%), and atopic dermatitis (1.7%), within 3 months before or after the first diagnosis of granuloma annulare.

“These results provide important information regarding the basic epidemiology and the overall burden of granuloma annulare in the United States,” wrote Barbiere and colleagues. “Future studies are needed to better understand the association of granuloma annulus with quality of life and the most optimal treatment approaches for this condition.”

The study, “Incidence and prevalence of granuloma annulare in the United States, was published online in JAMA Dermatology.

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