Australia Antigen Polyarteritis Treated with Prednisone and Dapsone

The wound/burn guidelines – 4: Guidelines for the management of skin ulcers associated with connective tissue disease/vasculitis

“…Comments: There are four case series studies regarding the usefulness of dapsone for the treatment of skin ulcers associated with rheumatoid vasculitis, and the evidence level is V. The administration of dapsone should be evaluated when a sufficient response to steroid or cyclophosphamide pulse therapy cannot be obtained in patients with a favorable prognosis such as those in whom leukocytoclastic vasculitis is histopathologically detected in the dermis, patients showing histopathological changes resembling those in polyarteritis nodosa and patients in whom the presence of arteritis is clinically suspected. Bernard et al . reported two patients in whom dapsone was effective for the control of intractable skin ulcers associated with rheumatoid vasculitis.…”

“…In both patients, leukocytoclastic vasculitis was histopathologically demonstrated in the dermis. Thus, dapsone may as well be regarded as an option for the treatment of rheumatoid vasculitis showing leukocytoclastic vasculitis of the dermis. dapsone has also been reported to be effective for cutaneous polyarteritis nodosa and polyarteritis nodosa . However, there is no clear evidence based on a comparative study, or a case report indicating its efficacy when administrated alone.…”

A near fatal case of the dapsone hypersensitivity syndrome in a patient with urticarial vasculitis

“…Dapsone is the drug of choice for treatment of leprosy and dermatitis herpitiformis. It has also been used for a variety of other dermatological conditions including Hailey–Hailey disease, 1 bullous pemphigoid, 2 leukocytoclastic and other forms of vasculitis 3,4 . The common side‐effects of dapsone include lethargy, headaches, methaemoglobinaemia and haemolysis.…”

“…It has also been used for a variety of other dermatological conditions including Hailey-Hailey disease, 1 bullous pemphigoid, 2 leukocytoclastic and other forms of vasculitis. 3,4 The common side-effects of dapsone include lethargy, headaches, methaemoglobinaemia and haemolysis. However, a more severe reaction, the dapsone hypersensitivity syndrome (DHS), may also occur in less than 1% of patients treated with dapsone.…”

Studies on vasculitis

“…Consequently the human lesions have been examined for antigen-antibody complexes that may have induced the damage. Australia antigen has been found in polyarteritis nodosa lesions (Gocke et al, 1970(Gocke et al, , 1971Trepo & Thivolet, 1970;Thompson, 1976) and globulin, possibly representing the antigenic portion of cryoglobulin complexes, in several forms of vasculitis (Cream, 1971(Cream, , 1973. There is less evidence for the presence of the antigen that may have combined with immunoglobulin to form a complex, but bacterial antigens have been identified in the lesions, and antigens from cultures of the bacteria shown to form complexes with the antibody of the patient, and activate complement to form tissue-damaging complexes (Parish & Rhodes, 1967;Parish, 1970Parish, , 1971.…”