Dapsone: use in immunobullous disorders
DOI:
https://doi.org/10.66344/jpad.15.2.2005.637Keywords:
Dapsone, toxicity, dermatitis herpetiformis, linear IgA disease, bullous pemphigoid, cicatricial pemphigoid, bullous SLE, epidermolysis bullosa acquisita, pemphigus.Abstract
Dapsone and other sulfonamides have been used successfully in the treatment of patients with
a variety of blistering skin diseases. The patients most likely to respond to dapsone therapy
have predominantly neutrophilic infiltrate in their skin e.g. dermatitis herpetiformis and linear
IgA disease. The precise mechanism of action of dapsone is unknown. In vitro studies have
shown that dapsone can interfere with the production of and response to neutrophilic
chemotactants and that it may impair the neutrophils' ability to localize to sites of
inflammation and produce toxic oxygen intermediates. The safe use of dapsone requires an
understanding of the pharmacology and adverse effects of the drug. Hemolytic anemia and
methemoglobinemia are two of the dose-related adverse effects. Agranulocytosis, motor
neuropathy, and dapsone hypersensitivity syndrome are some of the severe idiosyncratic
effects that can occur in patients treated with dapsone. Careful patient selection and close
monitoring of patients during therapy with dapsone are critical elements in the safe and
effective use of dapsone for patients with blistering skin diseases.
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