Mepacrine as successful monotherapy for refractory Jessner-Kanof disease: still an important drug in the dermatologic armamentarium.
BACKGROUND
Jessner-Kanof disease (JKD), a lymphocytic infiltration of the skin, can be difficult to treat. Mepacrine (quinacrine), an anti-malarial less available in Belgium, may be beneficial.


METHODS
Two female patients with biopsy-proven and therapy-resistant JKD, not responding to topical and systemic corticosteroids, (hydroxy-)chloroquine and/or dapsone, were treated with mepacrine 100 mg daily.


RESULTS
In both patients an amelioration was observed during the first month of treatment, and clinical remission was obtained by the fourth month, without any side-effects. In both cases, the dose could be tapered to three times weekly.


CONCLUSIONS
JKD is strongly related to lupus erythematosus (tumidus), and although spontaneous remissions may occur, it is notoriously difficult to treat. Mepacrine may be initiated as an add-on therapy to (hydroxy-)chloroquine, but also as monotherapy. A dose of 100 mg a day, tapered to weekly doses once remission is obtained, seems feasible. Except for (mild) yellow skin discoloration, the drug has few side-effects, and offers the advantage of not displaying retinal toxicity.


CONCLUSIONS
Mepacrine is still a useful and safe drug for treating cutaneous lupus erythematosus and related skin conditions, such as refractory JKD in particular. Its future availability, also in Belgium, is therefore important.
a Department of Dermatology , University Hospital Antwerp (UZA), University of Antwerp (UA) , Antwerp , Belgium.
Laura
L
Wuyts
a Department of Dermatology , University Hospital Antwerp (UZA), University of Antwerp (UA) , Antwerp , Belgium.
Julie
J
Dandelooy
b Department of Pathology , University Hospital Antwerp (UZA), University of Antwerp (UA) , Antwerp , Belgium.
Vasiliki
V
Siozopolou
a Department of Dermatology , University Hospital Antwerp (UZA), University of Antwerp (UA) , Antwerp , Belgium.
Julien
J
Lambert
a Department of Dermatology , University Hospital Antwerp (UZA), University of Antwerp (UA) , Antwerp , Belgium.
Olivier
O
Aerts
D000328:Adult; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004817:Epidermis / Q000473:pathology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy*; D008875:Middle Aged; D011796:Quinacrine / Q000627:therapeutic use*
D004791:Enzyme Inhibitors; D011796:Quinacrine
Anti-malarials; availability; lupus erythematosus; lymphocytic infiltration; quinacrine