Pentoxyfilline as a treatment for subcorneal pustular dermatosis

Abstract

Subcorneal pustular dermatosis (SPD) is a rare pustular neutrophilic dermatosis in which groups of sterile pustules appear in the superficial (subcorneal) skin. This chronic condition can be associated with significant morbidity and decreased quality of life. Dapsone is the first‐line therapy for SPD, but some patients fail to respond or cannot tolerate it. In these instances, patients may be treated with second‐line therapies such as phototherapy, topical corticosteroids, or systemic agents including glucocorticoids, acitretin, immunosuppressive, or biologic medications. These therapies may not always be efficacious and can be associated with intolerable adverse effects. Here, we report a case of a patient who sustained long‐term remission and no side effects with the novel use of pentoxifylline, a tumor necrosis factor‐alpha inhibitor, as monotherapy. Pentoxifylline should be considered as a possible therapy in patients with SPD intolerant to dapsone.

Treatment of Subcorneal Pustular Dermatosis without Dapsone: A Case Report and Review of the Literature

“…Falcone et al [55] "20s"-year-old female Pentoxifylline 400 mg TID: remission for 7 years, only one fare which was treated with prednisone 6 weeks (see Figure 2). Because the patient had experienced an increase in mild upper respiratory infections while on adalimumab, approximately three months after starting colchicine, she attempted discontinuation of adalimumab with concomitant increase of colchicine to 1.2 mg daily, but within two weeks of her last dose of adalimumab, she began to experience recrudescence of the lesions on the legs.…”

Pentoxifylline in dermatology

“…Pentoxifylline has been used with success in case reports of dermatologic diseases including post‐erysipelas panniculitis ossificans, pretibial myxedema of graves' disease, subcorneal pustular dermatosis, Kasabach–Merritt syndrome, calciphylaxis ulcers, sickle cell leg ulcers, toxic epidermal necrolysis and febrile ulceronecrotic Mucha–Habermann disease 68–77 …”