Diclofenac sodium 3% gel for darier's disease treatment

Abstract

Background: Darier's disease (DD) is an autosomal dominant skin disorder which causative gene, ATP2A2, is located at chromosome 12q23-24. The lesions of DD are skin-coloured to brown, hyperkeratotic, greasy papules that coalesce into warty plaques commonly involving the seborrhoeic areas of the trunk and face, especially the scalp margins, temples, ears, and scalp. The most common complaint associated with the disease is itching, with exacerbations attributed to heat, sweating, sunlight, lithium, steroid therapy, stress, and menstruation Objectives: We report a patient with DD treated with topical diclofenac sodium 3%.Methods: We report a 33-year-old patient with Darier's Disease. He was followed in our department since 2009, and we had tried to control several flares of lesions during follow-up, but oral isotretinoin was not tolerated because of adverse effects; and oral doxycycline showed lack of efficacy.At April 2014, patient presented with new lesions, involving anterior chest wall, abdomen, back and shoulders areas. We started with diclofenac sodium 3% in hyaluronic acid 2.5% once daily, only applied at abdomen and anterior chest wall.

Darier and Hailey‐Hailey disease: update 2021

“…There are also individual case reports on topical treatment with the following substances: –Vitamin‐D3 analogs (calcipotriol and tacalcitol), in most cases however worsening of the skin [45] –5‐Fluoruracil (1 % 1 x per day), inconsistent results [46] –Diclofenac gel 3 %, good response in four patients [47, 48] –Fusidinic acid [49] –Gentamicin [50] …”

“…-Vitamin-D3 analogs (calcipotriol and tacalcitol), in most cases however worsening of the skin [45] -5-Fluoruracil (1 % 1 x per day), inconsistent results [46] -Diclofenac gel 3 %, good response in four patients [47,48] -Fusidinic acid [49] -Gentamicin [50] A fundamental problem of topical treatments is that long-term use would be required for sustained results, but in reality application is restricted to limited areas due to increased absorption and for some agents also possible irritation.…”

Therapeutic Options for the Treatment of Darier’s Disease: A Comprehensive Review of the Literature

“…The use of diclofenac sodium gel for treatment of DD was described in multiple reports in the literature (Grade C evidence). 78 - 80 The proposed mechanism of action for this treatment is through COX-2 inhibition, which has the effect of upregulating production of the SERCA2 protein. 78 Patients using this treatment experienced moderate to significant clinical improvement of their DD lesions, without any notable side effects.…”

Morbus Darier und Morbus Hailey‐Hailey: Stand 2021

“…-Vitamin-D3-Analoga (Calcipotriol und Tacalcitol), in den meisten Fällen jedoch Verschlechterung des Hautbefundes [45] -5-Fluoruracil (1 % 1 x täglich), inkonstante Ergebnisse [46] -Diclofenac-Gel 3 %, gutes Ansprechen bei vier Patienten [47,48] -Fusidinsäure [49] -Gentamicin [50] Ein prinzipielles Problem topischer Therapien besteht darin, dass wegen der erhöhten Resorption und möglicher irritativer Nebenwirkungen einiger Substanzen nur umschriebene Areale behandelt werden können, für eine anhaltende Besserung jedoch eine langfristige Anwendung erforderlich wäre.…”

“…Darüber hinaus liegen Einzelfallberichte zu topischen Therapien mit folgenden Wirkstoffen vor: –Vitamin‐D3‐Analoga (Calcipotriol und Tacalcitol), in den meisten Fällen jedoch Verschlechterung des Hautbefundes [45] –5‐Fluoruracil (1 % 1 x täglich), inkonstante Ergebnisse [46] –Diclofenac‐Gel 3 %, gutes Ansprechen bei vier Patienten [47, 48] –Fusidinsäure [49] –Gentamicin [50] …”