Anterior ischaemic optic neuropathy associated with Dapsone

Chalioulias, K.; Mayer, Eric; Darvay, A.; Antcliff, Richard J

doi:10.1038/sj.eye.6702050

Cited by 16 publications

(8 citation statements)

References 10 publications

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“…Its chief use in ophthalmology is for the treatment of ocular cicactricial pemphigoid. The ocular side effect of dapsone are mainly attributable to its haemolytic effects when given at high doses, which can lead to obstruction of small-size vessels in the retina and optic nerve [42,43], but there are no reports of ocular side effects from its use at standard doses for rheumatological disease.…”

Section: Dapsonementioning

confidence: 99%

Ocular Complications of Drugs Used in Rheumatic Disease

Tam¹,

Taylor²,

Lightman

2011

CRR

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Systemically administered medications have long been known to produce detectable ophthalmic signs. Some of these are benign, asymptomatic phenomena that do not require screening or regular follow-up, such as the vortex keratopathy characteristic of amiodarone use, but other medications are potentially toxic to the eye and can damage vision. Ocular toxicity is an established side-effect of several of the immunosuppressive medications in routine use in rheumatological disease, including hydroxychloroqine, but corticosteroids can also cause ocular side-effects in the form of cataract and raised intraocular pressure. Ocular side-effects often occur in a dose-related and reversible manner, but some toxicity reactions are idiosyncratic, irreversible or may progress despite cessation of treatment.

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Section: Dapsonementioning

confidence: 99%

Ocular Complications of Drugs Used in Rheumatic Disease

Tam¹,

Taylor²,

Lightman

2011

CRR

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“…Table 4 presents the main adverse reactions to dapsone, classified as toxic and idiosyncratic. Such adverse effects are usually dose dependent and more common in patients with comorbidity (anaemia, cardiopulmonary disease, glucose‐6‐phosphate‐dehydrogenase deficiency) 38–45 . Dapsone can induce a severe hypersensitivity syndrome, consisting of fever, rash, malaise, lymphadenopathy, and varying degrees of visceral involvement, which develops in about 5% of dermatitis herpetiformis patients 2–6 weeks after the beginning of treatment 38–45 …”

Section: Therapymentioning

confidence: 99%

“…Dapsone represents a valid therapeutic option for dermatitis herpetiformis patients during the 1-to 2-year period until the GFD is effective; [38][39][40][41][42][43][44][45] dosages of 1/mg/kg/day can control itching and blister development. [38][39][40][41][42][43][44][45] Although dapsone does effectively decrease pruritus and inflammatory lesions, patients taking this drug should be strictly monitored (especially for renal and liver function) because of possible severe adverse effects. [38][39][40][41][42][43][44][45] In particular, the commonest side-effect of dapsone is haemolysis and patients should be seen within 2 weeks after starting the drug as haemolysis may be acute in some individuals.…”

Section: Dapsonementioning

confidence: 99%

“…[38][39][40][41][42][43][44][45] Although dapsone does effectively decrease pruritus and inflammatory lesions, patients taking this drug should be strictly monitored (especially for renal and liver function) because of possible severe adverse effects. [38][39][40][41][42][43][44][45] In particular, the commonest side-effect of dapsone is haemolysis and patients should be seen within 2 weeks after starting the drug as haemolysis may be acute in some individuals. Table 4 presents the main adverse reactions to dapsone, classified as toxic and idiosyncratic.…”

Section: Dapsonementioning

confidence: 99%

“…[38][39][40][41][42][43][44][45] Dapsone can induce a severe hypersensitivity syndrome, consisting of fever, rash, malaise, lymphadenopathy, and varying degrees of visceral involvement, which develops in about 5% of dermatitis herpetiformis patients 2-6 weeks after the beginning of treatment. [38][39][40][41][42][43][44][45] Sulfasalazine and sulphamethoxypyridazine might provide an effective alternative to dapsone especially when it fail to control the disease or the therapy is complicated by adverse events. 5,46,47 The suggested dosages are of 1-2 g/day for sulfasalazine and of 0.25-1.5 g/day for sulphamethoxypyridazine.…”

Section: Dapsonementioning

confidence: 99%

See 2 more Smart Citations

Guidelines for the diagnosis and treatment of dermatitis herpetiformis

Caproni

Antiga

Melani

et al. 2009

Acad Dermatol Venereol

179

222

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Case description: A 67 years old man presented to the clinic complaining of an itchy blistering skin rash over elbows, knees and buttocks for the past 2 months that is not responding to antihistamines. Itching has no diurnal variation. Patient has no chronic comorbidities a nd is not on regular medications. On examination, symmetrical vesicular lesions with erythema, crusting and itch marks are seen over both elbows, knees and back with-ve Nicolsky's sign. General examination reveals pallor, patient BMI 17.5, abdominal diste ntion, and peripheral neuropathy. Investigations showed microcytic hypochromic anemia with HGB 9.8 mg/dl, MCV 68, HCT 29.8, WBCs and platelets are normal. K 3.1 mg/dl, Na 135 meq/dl , Ca 8.5mg/dl, albumin 3 g/dl. Skin biopsy and direct immunofluorescence of t he skin around the lesions was taken that was diagnosed as dermatitis herpetiformis. Endoscopy was done and it confirmed the diagnosis of celiac disease.Treatment: Patient was advised to follow a gluten free diet plan and dapsone was started at a dose of 1 00 mg/day. Patient rash resolved gradually over a period of 3 weeks.

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Principles of Systemic Therapy

Tidman

Smith

2016

Rook's Textbook of Dermatology, Ninth Edition

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This chapter on systemic dermatological therapy aims to provide practising dermatologists with sufficient information about the most frequently used systemic medications to enable these to be used for treating skin disease to the maximum benefit and minimum detriment to their patients. The introduction covers general aspects of systemic therapy, including patient selection and education, risk reduction measures and the importance of good record keeping. Thereafter follows a detailed review of immunomodulatory and antimicrobial drugs, including antihistamines, antimalarial agents, azathioprine, ciclosporin, colchicine, dapsone, fumaric acid esters, glucocorticoids, hydroxycarbamide, methotrexate, mycophenolate mofetil, potassium iodide, protein therapies (biological drugs and intravenous immunoglobulin), retinoids, thalidomide, antibiotics, antifungal agents and antiviral drugs. The profile of each individual drug includes its pharmacological properties (formula and structure, pharmacodynamics, pharmacokinetics and, where relevant, pharmacogenetic aspects), potential adverse effects, contraindications, cautions, drug–drug interactions, pre‐treatment screening, dosage regimens, monitoring requirements and its range of licensed and off‐label dermatological usage.

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Anterior ischaemic optic neuropathy associated with Dapsone

Cited by 16 publications

References 10 publications

Ocular Complications of Drugs Used in Rheumatic Disease

Ocular Complications of Drugs Used in Rheumatic Disease

Guidelines for the diagnosis and treatment of dermatitis herpetiformis

Principles of Systemic Therapy

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