title: Treatment of antiviral-resistant recurrent erythema multiforme with dapsone.
abstract: Recurrent erythema multiforme (REM) is a chronic disease characterized by frequent episodes of target cutaneous lesions in an acral distribution. Conventional treatment includes systemic corticosteroids and antiviral therapy. The aim of this study was to evaluate dapsone as a potential steroid sparing-agent for the treatment of REM after a failed trial of at least one antiviral therapy (acyclovir, famciclovir, or valacyclovir). A retrospective chart review was conducted on thirteen patients with a diagnosis of REM who underwent treatment with dapsone after failing at least one antiviral therapy. Out of 13 patients, 6 showed complete response (CR) and 5 showed partial response (PR). The underlying cause was identified in 5 patients with all showing at least PR. Adverse effects, observed in 4 patients, included fatigue, macrocytic anemia, anxiety, insomnia and involuntary movements, and drug-induced lupus erythematosus. A continuous course of dapsone, titrated up from 25 mg/day to a dose at which clinical improvement is seen with acceptable patient tolerance, is a viable steroid sparing-agent for REM treatment after a failed trial of antiviral therapy.
authors.affiliation: Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Allen S W
authors.initials: AS
authors.lastname: Oak
authors.affiliation: Department of Dermatology, University of South Florida, Tampa, FL.
authors.forename: Lucia
authors.initials: L
authors.lastname: Seminario-Vidal
authors.affiliation: Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sami
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D003622:Dapsone / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D004892:Erythema Multiforme / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D000998:Antiviral Agents; D003622:Dapsone
keywords: dapsone; erythema multiforme