Mycophenolate mofetil for the treatment of chronic dermatitis: an open-label study of 16 patients.
BACKGROUND
Chronic dermatitis that is refractory to topical therapy poses a difficult treatment problem. Many patients are corticosteroid dependent. Mycophenolate mofetil (MMF) is a systemic B- and T-cell inhibitor that has some effect on delayed-type hypersensitivity. DESIGN, SETTING, INTERVENTIONS: In this open-label study conducted in a university-affiliated private practice setting, 16 patients with chronic and refractory eczema of three months duration or longer were enrolled consecutively into one of three cohorts based on dosage of MMF: five at 1 g/d, six at 1.5 g/d and five at 2.0 g/d. Patients in each cohort were allowed to increase dosage to a maximum of 3 g/d during the study. The authors evaluated the improvement of eczema and the presence of side effects over a 34-week period. Trends in patient and investigator global assessments were analyzed with the fitting of models using generalized estimating equations (GEE).


METHODS
To determine the efficacy and safety of mycophenolate mofetil (MMF) in the treatment of chronic and refractory eczema.


RESULTS
Twelve of 16 patients improved by patient global assessment and 14 of 16 patients improved by investigator global assessment during the study. Three patients cleared completely and six patients were almost clear. MMF was well-tolerated. One patient experienced a serious adverse event (pancreatic cancer), early in the study, while on therapy. This patient had dermatitis that improved, but pruritus that was out of proportion to exam and a further workup to evaluate newly elevated liver functions after study initiation revealed the pancreatic cancer.


CONCLUSIONS
Mycophenolate mofetil is an effective and well-tolerated treatment for some patients with chronic dermatitis.
Jackson
J Mark
JM
University of Louisville, Division of Dermatology, Louisville, KY 40202, USA. kmmjackson@aol.com
Fowler
Joseph F
JF
Callen
Jeffrey P
JP
Lorenz
Douglas J
DJ
D001830:Body Surface Area; D002908:Chronic Disease; D004485:Eczema / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid