Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study

Abstract

Background: Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease. Most patients require long-term therapy with systemic steroids, and a steroid-sparing agent is usually also utilized. Dapsone is a chemotherapeutic agent with anti-inflammatory properties that is used as a steroid-sparing agent in PV. Objective: The aim of the present study was to evaluate the efficacy of dapsone as an adjuvant therapy in patients with PV. Methods: A retrospective analysis of patients' files was performed. All 26 patients included in the study group were treated with dapsone as an adjuvant to systemic steroids for at least 3 consecutive months and were followed up during their dapsone treatment period. Results: After 3 months of treatment with dapsone, 13 patients were in the consolidation phase, 4 patients demonstrated partial remission on minimal therapy, 7 patients demonstrated complete remission on minimal therapy, and 2 patients were defined as treatment failures. The trend of clinical improvement continued after 6 months of treatment and at the study end point. Conclusion: This retrospective case series, one of the largest reported, indicates that dapsone is efficacious and safe for patients with PV in whom it is well tolerated soon after the initiation of treatment.

Epidemiology and Factors Associated with Remission of Pemphigus Vulgaris and Foliaceus in Singapore

“…24 Other studies have also reported similar associations with hypertension, diabetes and hyperlipidaemia. 5,8,12,15,[25][26] None of the pemphigus patients in our study was reported to have thyroid disorders, contrary to previous reports. 9,15,19,25,26 Two PV patients had prior malignancy of nasopharyngeal cancer and breast ductal carcinoma in situ, respectively.…”

“…5,8,12,15,[25][26] None of the pemphigus patients in our study was reported to have thyroid disorders, contrary to previous reports. 9,15,19,25,26 Two PV patients had prior malignancy of nasopharyngeal cancer and breast ductal carcinoma in situ, respectively. Although previous studies 27 had suggested an association of PV with internal malignancy, no significant association was found in our study.…”

Dapsone in the Management of Pemphigus and Pemphigoid: Rediscovery of its Long-Lost Efficacy

“…And on the other hand, one patient responded completely to dapsone although he/she had no neutrophils infiltration. Furthermore, dapsone was also noted as effective in multiple cases of PV [26][27][28][29][30]. A series of three cases were reported by Piamphongsant et al each having distinct clinical scenarios that all responded to dapsone.…”

Side effects of steroid-sparing agents in patients with bullous pemphigoid and pemphigus: A systematic review

“…Tables I 8 , 10 , 12 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 and II 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 illustrate summarized compilations of the RCTs and RCSs carried out to evaluate the adjuvant therapies used in patients with BP and pemphigus, respectively. The confidence of the data presented in this systematic review is ensured based on clear inclusion and exclusion criteria; the search was comprehensive, in that, appropriate databases were used, and there was neither a language bias (no restriction of inclusion based on language) nor restriction of inclusion based on publication status.…”