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Granuloma annulare — SCE Dermatology MCQ

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HardGeneral dermatology & dermatology in primary health careGranuloma annulareSCE Dermatology

Segmental facial vitiligo has been unchanged for 30 months with no Koebner phenomenon and has not responded to optimized topical therapy or narrowband UVB. Which escalation is most defensible?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Assess autologous melanocyte transfer for stable treatment-resistant disease

Explanation lettering: C = shown as A · E = shown as B · D = shown as C · B = shown as D · A = shown as E

A is correct. BAD guidance reserves surgical repigmentation for selected stable, treatment-resistant vitiligo, with stable segmental disease among the most favourable settings. Stability and absence of Koebner activity reduce the risk that ongoing disease will destroy transplanted melanocytes. Techniques use the patient’s own epidermal tissue or melanocytes; donor cells are not routine. Systemic corticosteroids may be used briefly to arrest rapidly progressive disease, not as prolonged prerequisite therapy in stable disease. Site, scarring tendency, expectations and local expertise influence selection.

Reference: BAD guideline for vitiligo: https://doi.org/10.1111/bjd.20596