{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T22:48:14Z","timestamp":1783810094527,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Disseminated granuloma annulare (<jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>) is a rare granulomatous dermatitis of unknown etiology. Treatment is often challenging and lack of a uniformly effective treatment, adds to the disease morbidity. Tumor necrosis factor (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>)\u2010\u03b1 is an important cytokine in granuloma formation and previous reports have shown improvement of disseminated <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> with anti\u2010<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 therapy. Nevertheless, the underlying mechanism of actions of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 inhibitors in <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> remains unclear. Our aim was to evaluate alterations in the inflammatory infiltrate in a patient who experienced complete clearance of <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> after treatment with infliximab. A skin biopsy was obtained before and 24\u00a0weeks after treatment with infliximab 5\u00a0mg\/kg at weeks 0, 2, 6, 14 and 24. Immunohistochemical stains were performed in pre\u2010 and post\u2010treatment biopsy specimens using <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>1a, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>8, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>11c, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>32, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>68, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>69, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>163, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>183 and human leukocyte antigen (<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>)\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content> to characterize alterations of the infiltrates. Parallel with clinical improvement, we observed a marked decrease in myeloid (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>11c) dendritic cells, different macrophage subsets (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>68, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>32, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>163) and T cells. In addition, a marked reduction of activation markers (<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CD<\/jats:styled-content>69) and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>183<jats:sup>+<\/jats:sup> (<jats:styled-content style=\"fixed-case\">CXCR<\/jats:styled-content>3) cells was observed in post\u2010treatment biopsy specimens. In conclusion, the clinical improvement of disseminated <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> by infliximab is paralleled by inhibition of activated myeloid dendritic cells, different macrophage subsets and type 1 T cells.<\/jats:p>","DOI":"10.1111\/1346-8138.14981","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T09:25:16Z","timestamp":1562750716000},"page":"808-811","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Infliximab reduces activated myeloid dendritic cells, different macrophage subsets and <scp>CXCR<\/scp>3\u2010positive cells in granuloma annulare"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1412-1869","authenticated-orcid":false,"given":"Christina","family":"B\u00fcrgler","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, Inselspital Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshavamurthy","family":"Vinay","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"H\u00e4fliger","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Inselspital Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Wilhelm","family":"Kl\u00f6tgen","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Inselspital Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Yawalkar","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Inselspital Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.03.055"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12976"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.12.033"},{"key":"e_1_2_5_5_1","first-page":"42","article-title":"Treatment of widespread granuloma annulare with adalimumab: a case report","volume":"4","author":"Kozic H","year":"2011","journal-title":"J Clin Aesthet 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