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Biologic and Systemic Agents in Dermatology pp 199–208Cite as

Fumaric Acid Esters in Dermatology

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Abstract

Fumaric acid esters (FAEs) have become a drug of increasing interest in the field of dermatology. Although they lack approval in the United States for the treatment of psoriasis, they have been widely used in Germany since their introduction in 1959. FAEs have been administered as enteric-coated tablets Fumaderm® Initial and Fumaderm®. The proposed mechanism of action is inhibition of keratinocyte proliferation and modulation of cytokine expression. FAEs have been used in the treatment of psoriasis, granulomatous diseases, and alopecia areata. Side effects such as gastrointestinal events and flushing are commonly experienced but often reversible upon cessation or adjustment of therapy. Although serious adverse events are rare, patients should be closely monitored for fluctuations in laboratory values and clinical abnormalities. The available literature suggests that with proper monitoring and adjustment as needed, FAEs may be an effective and safe long-term treatment alternative to other mainstay drugs used to treat psoriasis.

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Abbreviations

Bath PUVA:

Bath photochemotherapy

BSA:

Body surface area

CLE:

Cutaneous lupus erythematosus

DLE:

Discoid lupus erythematosus

DMF:

Dimethyl fumarate

DTIC:

Dacarbazine; anticancer chemotherapy drug

FAE(s):

Fumaric acid ester(s)

GSH:

Glutathione; antioxidant

MEF:

Monoethylfumarate

MMF:

Monomethylfumarate

NFkB:

Nuclear factor-kappa B

NL:

Necrobiosis lipoidica

PASI:

Psoriasis Area and Severity Index

PGA:

Physician’s Global Assessment

PPP:

Psoriasis pustulosa palmoplantaris

PPPASI:

Palmo-plantar Pustular Psoriasis Area Severity Index

RCLASI:

Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index

SCID:

Severe combined immunodeficiency

SCLE:

Subacute cutaneous lupus erythematosus

VEGFR2:

Vascular endothelial growth factor receptor 2

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Authors and Affiliations

  1. School of Medicine, UC Irvine Medical Center, University of California, Irvine, CA, 92617, USA

    Katrina Lee BS

  2. Clinical Research, Southern California Dermatology, Inc, Santa Ana, CA, 92701, USA

    Amber Alcaraz BA & Jennifer Soung MD

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  1. Katrina Lee BS
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  2. Amber Alcaraz BA
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  3. Jennifer Soung MD
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Correspondence to Jennifer Soung MD .

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Editors and Affiliations

  1. Division of Dermatology, David Geffen School of Medicine a UCLA, Los Angeles, California, USA

    Paul S. Yamauchi

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Lee, K., Alcaraz, A., Soung, J. (2018). Fumaric Acid Esters in Dermatology. In: Yamauchi, P. (eds) Biologic and Systemic Agents in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-66884-0_20

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  • DOI: https://doi.org/10.1007/978-3-319-66884-0_20

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