Off‐label use of fumarate therapy for granulomatous and inflammatory skin diseases other than psoriasis vulgaris: a retrospective study

Abstract

According to this data, fumarates may represent a new approach in the treatment of granulomatous and inflammatory skin diseases other than psoriasis vulgaris. For the first time, the successful treatment of LP and CDLE with fumarates is reported. Side-effects are not limiting in most cases, but can hamper a dose escalation.

Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus

“…DMF induces apoptosis of activated T cells, interferes with the glutathione metabolism, inhibits the transcription and protein expression of inflammatory cytokines and affects adhesion molecule expression implicated in leucocyte extravasation. It has successfully been used for lichen planus, granuloma annulare, pityriasis rubra pilaris and chronic discoid lupus erythematosus (Klein ). Its use in LS is not reported in the literature, however, there are occasional unpublished observations of the successful use of fumarates in LS.…”

Multi-Organ Sarcoidosis Treatment with Fumaric Acid Esters: A Case Report and Review of the Literature

“…Treatment with FAEs has been reported to be effective in small case series and case reports of patients with sarcoidosis [5,6,11,12,13,14], while marked to complete remission of skin and pulmonary lesions has been reported (table 1). Dümmler et al [11] presented 2 patients with cutaneous sarcoidosis treated with FAEs.…”

“…Treatment with FAEs has been reported to be effective not only in patients with sarcoidosis but also with other granulomatous diseases, such as disseminated granuloma annulare and necrobiosis lipoidica [5,6,7]. Recently, four cases with virus-related progressive multifocal encephalopathy (PML) were reported in patients with psoriasis under FAEs treatment [15].…”

“…Side effects were usually mild and resolved spontaneously upon dose reduction or discontinuation of the therapy. Klein et al [6] treated 10 patients with non-infectious granulomatous diseases with FAEs, among them a 43-year-old male with cutaneous sarcoidosis who only exhibited initial partial response. Finally, Wolter et al [14] presented a 43-year-old male with systemic sarcoidosis whose cutaneous and pulmonary lesions markedly responded after 6 months of FAEs treatment and almost completely cleared after 11 months of FAEs treatment.…”

“…Beyond that, several reports have described an effect of FAEs on granulomatous skin diseases such as sarcoidosis, necrobiosis lipoidica and granuloma annulare [5,6,7]. However, very little is known about their mechanism(s) of action.…”