Hematologic Safety of Dapsone Gel, 5%, for Topical Treatment of Acne Vulgaris

Piette, Warren W.; Taylor, Susan C.; Pariser, David M.; Jarratt, Michael; Sheth, Pranav; Wilson, David J.

doi:10.1001/archdermatol.2008.518

Cited by 59 publications

(34 citation statements)

References 14 publications

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“…92,93 The safety of 5% dapsone gel applied twice daily has been demonstrated in patients who are glucose 6 phosphate dehydrogenase-deficient and in patients who are sulfonamide allergic. [94][95][96] The most common applicationsite reactions consisted of erythema and dryness that were similar between groups. A temporary orange staining of the skin can occur when BP and topical dapsone are used together.…”

Section: Topical Dapsonementioning

confidence: 99%

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

et al. 2013

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INTRODUCTION: Acne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms. METHODS: Ten major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed. RESULTS: Recommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed. CONCLUSIONS: These expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients.

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Section: Topical Dapsonementioning

confidence: 99%

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

et al. 2013

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“…S8), suggesting that DDS is not life-threatening in humans. Recently, a 5% DDS gel, which achieves a plasma concentration of about 20 μM, was reported to be safe and effective for longterm treatment (31). If DDS is to be used in a safer way, the treatment of DDS at a lower concentration may be more beneficial.…”

mentioning

confidence: 99%

DDS, 4,4′-diaminodiphenylsulfone, extends organismic lifespan

Cho

Park

Keam

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

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DDS, 4,4′-diaminodiphenylsulfone, is the most common drug prescribed to treat Hansen disease patients. In addition to its antibacterial activity, DDS has been reported to be involved in other cellular processes that occur in eukaryotic cells. Because DDS treatment significantly enhances the antioxidant activity in humans, we examined its effect on lifespan extension. Here we show that DDS extends organismic lifespan using Caenorhabditis elegans as a model system. DDS treatment caused a delay in aging and decreased the levels of a mitochondrial complex. The oxygen consumption rate was also significantly lowered. Consistent with these data, paraquat treatment evoked less reactive oxygen species in DDS-treated worms, and these worms were less sensitive to paraquat. Interestingly enough, all of the molecular events caused by DDS treatment were consistently reproduced in mice treated with DDS for 3 mo and in the C2C12 muscle cell line. Structural prediction identified pyruvate kinase (PK) as a protein target of DDS. Indeed, DDS bound and inhibited PK in vitro and inhibited it in vivo, and a PK mutation conferred extended lifespan of C. elegans. Supplement of pyruvate to the media protected C2C12 cells from apoptosis caused by paraquat. Our findings establish the significance of DDS in lowering reactive oxygen species generation and extending the lifespan, which renders the rationale to examining the possible effect of DDS on human lifespan extension.F irst synthesized a century ago, 4,4′-diaminodiphenylsulfone (DDS) is a drug still used to treat many skin diseases. Specifically, DDS is a principal drug in a multidrug regimen recommended by the World Health Organization for the treatment of leprosy (1-4). DDS acts as an antibiotic in a manner similar to sulphonamides by inhibiting bacterial synthesis of dihydrofolic acid through competition with para-aminobenzoic acid (PABA) for the active site of dihydropteroate synthetase (DHPS) (5). In addition to its antibacterial activity, DDS has been reported to be involved in other cellular processes that occur in eukaryotic cells, such as inflammation, migration, and apoptosis (6). However, there has been controversy over the issue of whether DDS acts as a pro-oxidant (especially when a higher dose of DDS is used rather than a standard dose) or antioxidant (7-9). Most studies on the pro-oxidant effects of DDS have been based on its use at high concentrations. For example, in human dermal fibroblasts, a high dose of DDS (1.5 mM) induced oxidative stress and glutathione depletion (10), but in rat livers, DDS administration at a dose of 30 mg/kg body weight resulted in oxidative stress (11). Therefore, the debate regarding the nature of DDS as a pro-oxidant or antioxidant appears to reflect the dosage effect. Another interesting observation is that Hansen disease patients in Korea, who usually have taken DDS for several decades, had a longer lifespan in spite of their socioeconomical disadvantages (12). This finding prompted us to examine whether and how DDS treatment extends an...

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“…Clinical studies have shown that dapsone gel 5% was effective in the treatment of acne vulgaris [5] with approximately 1% of the systemic exposure that is seen with typical oral dapsone treatment [13,14]. After treatment with dapsone gel 5%, no clinical or laboratory evidence of drug induced hemolytic anaemia was noted in G6PD deficient subjects with acne vulgaris [15].…”

Section: Resultsmentioning

confidence: 99%

Comparative Study of Efficacy of Topical Dapsone 5% Gel, Topical Benzoyl Peroxide 2.5% Alone and in Combination in Acne Vulgaris Patients

Sarojini¹,

Nageswaramma²,

Sirisha³

et al. 2016

IOSR

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Hematologic Safety of Dapsone Gel, 5%, for Topical Treatment of Acne Vulgaris

Abstract: To evaluate the risk of hemolysis in subjects with glucose-6-phosphate dehydrogenase (G6PD) deficiency who were treated for acne vulgaris with either dapsone gel, 5% (dapsone gel), or vehicle gel.

Cited by 59 publications

References 14 publications

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

DDS, 4,4′-diaminodiphenylsulfone, extends organismic lifespan

Comparative Study of Efficacy of Topical Dapsone 5% Gel, Topical Benzoyl Peroxide 2.5% Alone and in Combination in Acne Vulgaris Patients

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