Granuloma annulare; dissemination following administration of calciferol.

The therapeutic effectiveness of calciferol in cases of lupus vulgaris reported by Charpy 1 and by Dowling and Thomas 2 has been confirmed by many investigators. In the course of studies on the drug the use of calciferol has been extended to other forms of cutaneous tuberculosis as well as to other eruptions whose relationship to tuberculosis is not completely understood. Granuloma annulare may be placed in the latter group. Although its relationship to tuberculosis has been suggested in the past, most authorities now agree that, despite the occasional coincidence of tuberculosis elsewhere in the body, the clinical and histopathological observations speak against a tuberculous etiology of granuloma annulare. Pascher, Silverberg, Marks and Markel 3 reported on five cases of granuloma annulare in their therapeutic assay of calciferol. In discussing their results they stated that widespread dissemination of the lesions occurred in two patients while they were taking calciferol. These