The protective effect of vitamin E on the hemolysis associated with dapsone treatment in patients with dermatitis herpetiformis

Prussick, R.

doi:10.1001/archderm.128.2.210

Cited by 17 publications

(9 citation statements)

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“…Studies investigating the coadministration of medications to try and increase dapsone tolerance have produced varying results, and there is a lack of large, randomized controlled trials to confirm the findings. Studies on vitamin E have found no effect [26] or a partial protective effect when 800 units were administered for 4 weeks [27]. Studies on vitamin C doses that are >1 m M (attainable by intravenous administration) have found methemoglobinemia reduction; however, oral administration cannot exceed 200 µ M because of the gastrointestinal absorption [28,29,30].…”

Section: Discussionmentioning

confidence: 99%

Dapsone Therapy for Pustular Psoriasis: Case Series and Review of the Literature

Sheu¹,

Divito²,

Enamandram³

et al. 2015

Dermatology

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Background: Pustular psoriasis is an uncommon psoriasis variant, clinically characterized as small sterile pustules on an erythematous base. Evidence for therapy is lacking, and many currently employed systemic therapeutics carry risks of significant side effects, without specifically targeting disease etiology which includes the aggregation of neutrophils. Observations: We report therapy with the anti-neutrophil agent dapsone in 5 patients with pustular psoriasis and provide a brief review of the literature. Four patients responded to oral dapsone and 1 to topical dapsone therapy. All 5 patients had previously failed multiple topical and systemic treatments. In 2 cases, oral dapsone allowed for the discontinuation of other systemic agents. One patient stopped oral dapsone due to a side effect of sleep disturbance. Conclusion: Dapsone has a much safer side effect profile and may target the pathophysiology of pustular psoriasis more directly than many other systemic agents. As such, dapsone should be considered for the treatment of patients with pustular psoriasis.

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Section: Discussionmentioning

confidence: 99%

Dapsone Therapy for Pustular Psoriasis: Case Series and Review of the Literature

Sheu¹,

Divito²,

Enamandram³

et al. 2015

Dermatology

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“…As another strategy, various antioxidants like ascorbic acid and vitamin E have been examined. Neither a dose of 1000 mg ascorbic acid/day [89, 127, 146] nor 800 mg vitamin E had a significant effect on dapsone-induced haemolysis [127]. Only simultaneous application of ascorbic acid and vitamin E exerted an inhibitory effect on met-Hb formation [127].…”

Section: Conclusion For Treating Patients With Dapsonementioning

confidence: 99%

“…Neither a dose of 1000 mg ascorbic acid/day [89, 127, 146] nor 800 mg vitamin E had a significant effect on dapsone-induced haemolysis [127]. Only simultaneous application of ascorbic acid and vitamin E exerted an inhibitory effect on met-Hb formation [127]. The reason for these conflicting results might be attributable to the design of the studies which at that time were not GCP-based (no randomization, blinding or placebo controls).…”

Section: Conclusion For Treating Patients With Dapsonementioning

confidence: 99%

Dapsone in dermatology and beyond

2013

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Dapsone (4,4′-diaminodiphenylsulfone) is an aniline derivative belonging to the group of synthetic sulfones. In 1937 against the background of sulfonamide era the microbial activity of dapsone has been discovered. Shortly thereafter, the use of dapsone to treat non-pathogen-caused diseases revealed alternate antiinflammatory mechanisms that initially were elucidated by inflammatory animal models. Thus, dapsone clearly has dual functions of both: antimicrobial/antiprotozoal effects and anti-inflammatory features similarly to non-steroidal anti-inflammatory drugs. The latter capabilities primarily were used in treating chronic inflammatory disorders. Dapsone has been investigated predominantly by in vitro methods aiming to get more insights into the effect of dapsone to inflammatory effector cells, cytokines, and/or mediators, such as cellular toxic oxygen metabolism, myoloperoxidase-/halogenid system, adhesion molecules, chemotaxis, membrane-associated phospholipids, prostaglandins, leukotrienes, interleukin-8, tumor necrosis factor α, lymphocyte functions, and tumor growth. Moreover, attention has been paid to mechanisms by which dapsone mediates effects in more complex settings like impact of lifespan, stroke, glioblastoma, or as anticonvulsive agent. Additionally, there are some dermatological investigations in human being using dapsone and its metabolites (e.g., leukotriene B4-induced chemotaxis, ultraviolet-induced erythema). It could be established that dapsone metabolites by their own have anti-inflammatory properties. Pharmacology and mechanisms of action are determining factors for clinical use of dapsone chiefly in neutrophilic and/or eosinophilic dermatoses and in chronic disorders outside the field of dermatology. The steroid-sparing effect of dapsone is useful for numerous clinical entities. Future avenues of investigations will provide more information on this fascinating and essential agent.

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“…3 , 6 Daily administration of 800 units of vitamin A for 4 weeks could help prevent this side effect. 3 , 84 …”

Section: Treatmentmentioning

confidence: 99%

Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment

Clarindo

Possebon

Soligo

et al. 2014

An. Bras. Dermatol.

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Researches on DH have shown that it is not just a bullous skin disease, but a cutaneous-intestinal disorder caused by hypersensitivity to gluten. Exposure to gluten is the starting point of an inflammatory cascade capable of forming autoantibodies that are brought to the skin, where they are deposited, culminating in the formation of skin lesions. These lesions are vesico-bullous, pruritic, and localized especially on elbows, knees and buttocks, although atypical presentations can occur. Immunofluorescence of perilesional area is considered the gold standard for diagnosis, but serological tests help in cases where it is negative. Patients who follow glutenfree diets have better control of symptoms on the skin and intestine, as well as lower risks of progression to lymphoma. Dapsone remains the main drug for treatment, but it requires monitoring of possible side effects, some potentially lethal.

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The protective effect of vitamin E on the hemolysis associated with dapsone treatment in patients with dermatitis herpetiformis

Cited by 17 publications

References 0 publications

Dapsone Therapy for Pustular Psoriasis: Case Series and Review of the Literature

Dapsone Therapy for Pustular Psoriasis: Case Series and Review of the Literature

Dapsone in dermatology and beyond

Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment

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