Mycophenolate in dermatology.
Originally used to treat psoriasis nearly three decades ago, mycophenolic acid, reformulated as mycophenolate mofetil (MMF), has been rediscovered by the world of dermatology. As a relatively well-tolerated immunosuppressive used in organ transplant recipients, MMF has recently been reported to show promise for several dermatologic conditions, including psoriasis, pemphigus vulgaris, pyoderma gangrenosum, bullous lichen planus, and even connective tissue diseases such as lupus erythematosus and dermatomyositis. Although not intended to be exhaustive, this review discusses MMF with regard to its basic pharmacology, its side effects, and its reported efficacy in a variety of dermatologic indications. Relevant literature was retrieved by a Medline search combining the terms "mycophenolate" or "mycophenolic acid" and "skin" or "skin disease" or a number of specific conditions ("psoriasis", "dermatitis", "eczema", "pemphigoid", "pemphigus", "vasculitis", "pyoderma gangrenosum", "Crohn's disease", "graft-versus-host disease", "lichen planus"). As MMF has only been recently re-introduced for dermatologic application, the nature of much of the literature is admittedly that of case reports or case series. Nevertheless, the results are sufficiently promising to warrant further larger, control studies.
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Department of Dermatology, Harvard Medical School, Massachusetts General Hospital Dermatopathology Unit, 55 Fruit Street, Boston, MA 02114, USA. bmackool@partners.org
Mackool
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D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004485:Eczema / Q000188:drug therapy; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D008010:Lichen Planus / Q000188:drug therapy; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D011247:Pregnancy; D011565:Psoriasis / Q000188:drug therapy; D017511:Pyoderma Gangrenosum / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012871:Skin Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy; D016896:Treatment Outcome
D009173:Mycophenolic Acid