Skip to main content
SpringerLink
Log in

Dapsone in Dermatology

  • Chapter
  • First Online:
Biologic and Systemic Agents in Dermatology

Abstract

Dapsone is an antibacterial and anti-inflammatory agent with multiple uses in dermatology.

Also known as DDS, it may be administered orally or topically.

As antibacterial it disrupts the formation of a precursor of dihydrofolic acid from para-aminobenzoic acid (PABA), disrupting amino acid synthesis. As anti-inflammatory it inhibits myeloperoxidase, implicated in the formation of hypochlorous acid which causes tissue inflammation.

We found reports of its use in almost 50 different dermatologic entities reviewing just the last decade of publications and hereby summarize the most relevant. We also discuss its indications, contraindications, adverse events, monitorization, dosing, and presentations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Singh AR, et al. Efficacy of steroidal vs non-steroidal agents in oral lichen planus: a randomized, open-label study. J Larngol Otol. 2017;131(1):69–76.

    Article  CAS  Google Scholar 

  2. Yost JM, et al. Dermatitis herpetiformis. Dermatol Online J. 2014;20(12).

    Google Scholar 

  3. Clarindo MV, et al. Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment. An Bras Dermatol. 2014;89(6):865–75.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kuhn A, et al. S2k guideline for treatment of cutaneous lupus erythematosus. J Eur Acad Dermatol Venereol. 2017;31(3):389–404.

    Article  CAS  PubMed  Google Scholar 

  5. Klebes M, et al. Dapsone as second-line treatment for cutaneous lupus erythematosus? A retrospective analysis of 34 patients and a review of the literature. Dermatology. 2016;232(1):91–6.

    Article  CAS  PubMed  Google Scholar 

  6. Theirs BH, et al.. Dermatologic clinics. Philadelphia: Elsevier Saunders.

    Google Scholar 

  7. Moura FM, et al. Dapsone and body mass index in subjects with multibacillary leprosy. Ther Drug Monit. 2014;36(2):261–3.

    Article  CAS  PubMed  Google Scholar 

  8. van Zyl JM, et al. Mechanisms by which clofazimine and dapsone inhibit the myeloperoxidase system: a possible correlation with their anti-inflammatory properties. Biochem Pharmacol. 1991;42(3):599–608.

    Article  PubMed  Google Scholar 

  9. Kosseifi SG, et al. The dapsone hypersensitivity syndrome revisited: a potentially fatal multisystem disorder with prominent hepatopulmonary manifestations. J Occup Med Toxicol. 2006;1:9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Staub J, et al. Successful treatment of PASH syndrome with infliximab, cyclosporine and dapsone. J Eur Acad Dermatol Venereol. 2015;29(11):2243–7.

    Article  CAS  PubMed  Google Scholar 

  11. Faghihi G, et al. The efficacy of 5% dapsone gel plus oral isotretinoin versus oral isotretinoin alone in acne vulgaris: A randomized double-blind study. Adv Biomed Res. 2014;3:177.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Thiboutot DM, et al. Efficacy, safety, and dermal tolerability of dapsone gel, 7.5% in patients with moderate acne vulgaris: a pooled analysis of two phase 3 trials. J Clin Aesthet Dermatol. 2016;9(10):18–27.

    Google Scholar 

  13. Lnde CW, et al. Cohort study on the treatment with dapsone 5% gel of mid to moderate inflammatory acne of the face in women. Skinmed. 2014;12(1):15–21.

    Google Scholar 

  14. Tanghetti E, Harper JC, Oefelein MG. The efficacy and tolerability of dapsone 5% gel in female vs male patients with facial acne vulgaris: gender as a clinically relevant outcome variable. J Drugs Dermatol. 2012;11(12):1417–21.

    CAS  PubMed  Google Scholar 

  15. Tanghetti E, et al. Clinical evidence for the role of a topical anti-inflammatory agent in comedonal acne: findings from a randomized study of dapsone gel 5% in combination with tazarotene cream 0.1% in patients with acne vulgaris. J Drugs Dermatol. 2011;10(7):783–92.

    CAS  PubMed  Google Scholar 

  16. Stein Gold LF, et al. Efficacy and safety of once-daily dapsone gel 7.5% for treatment of adolescents and adults with acne vulgaris: first of two identically designed, large, multicenter, randomized, vehicle-controlled trials. J Drugs Dermatol. 2016;15(5):553–61.

    PubMed  Google Scholar 

  17. Jarratt MT, et al. Safety and pharmacokinetics of once-daily dapsone gel, 7.5% in patients with moderate acne vulgaris. J Drugs Dermatol. 2016;15(10):125–1259.

    Google Scholar 

  18. Bartless KB, et al. Tolerability of topical antimicrobials in treatment of acne vulgaris. J Drugs Dermatol. 2014;13(6):658–62.

    Google Scholar 

  19. Eichenfield LF, et al. Efficacy and safety of once-daily dapsone gel, 7.5% for treatment of adolescents and adults with acne vulgaris: second of two identically designed, large, multicenter, randomized, vehicle-controlled trials. J Drugs Dermatol. 2016;15(8):962–9.

    PubMed  Google Scholar 

  20. Farrah G, Tan E. The use of oral antibiotics in treating acne vulgaris: a new approach. Dermatol Ther. 2016;29(5):377–84.

    Article  PubMed  Google Scholar 

  21. Mendes FB, et al. Review: dermatitis herpetiformis. An Bras Dermatol. 2013;88(4):594–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Burbidge T, et al. Topical Dapsone 5% gel as an effective therapy in dermatitis Herpetiformis. J Cutan Med Surg. 2016;20(6):600–1.

    Article  PubMed  Google Scholar 

  23. Plotnikova N, et al. Dermatitis herpetiformis. Skin Therapy Lett. 2013;18(3):1–3.

    PubMed  Google Scholar 

  24. Cardones AR, et al. Management of dermatitis herpetiformis. Dermatol Clin. 2011;29(4):631–5.

    Article  CAS  PubMed  Google Scholar 

  25. Ozturk Z, et al. Leprosy treatment during pregnancy and breastfeeding: a case report and brief review of literature. Dermatol Ther. 2017;30(1).

    Google Scholar 

  26. Sung SM, et al. Diagnosis and treatment of leprosy type 1 (reversal) reaction. Cutis. 2015;95(4):222–6.

    PubMed  Google Scholar 

  27. Mofin-Maciel BM, et al. Immunological evaluation during treatment of a case of borderline lepromatous leprosy. Rey Alerg Mex. 2016;63(4):413–9.

    Google Scholar 

  28. Goto M, et al. Guidelines for the treatment of Hansen’s disease in Japan (third edition). Nihon Hansenbyo Gakkai Zasshi. 2013;82(3):143–84.

    Article  PubMed  Google Scholar 

  29. Eichelmann K. Leprosy, an update: definition, pathogenesis, classification, diagnosis, and treatment. Actas Dermosifiliogr. 2013;104(7):554–63.

    Article  CAS  PubMed  Google Scholar 

  30. Legendre DP. Hansen’s disease (Leprosy): current and future pharmacotherapy and treatment of disease-related immunologic reactions. Pharmacoherapy. 2012;32(1):27–37.

    Article  CAS  Google Scholar 

  31. Ortonne N. Cutaneous neutrophils infiltrates, Case 2. Erythema elevatum diutinum, late stage. Ann Pathol. 2011;31(3):173–7.

    Article  PubMed  Google Scholar 

  32. Seneschal J. Alternative procedure to allow continuation of dapsone therapy despite serious adverse reaction in a case of dapsone-sensitive erythema elevatum diutinum. Dermatology. 2012;224(2):115–9.

    Article  PubMed  Google Scholar 

  33. Frieling GW. Novel use of topical dapsone 5% gel for erythema elevatum diutinum: safer and effective. J Drugs Dermatol. 2013;12(4):481–4.

    PubMed  Google Scholar 

  34. Scheinfeld N. Hidradenitis suppurativa: a practical review of possible medical treatments based on over 350 hidradenitis patients. Dermatol Online J. 2013;19(4):1.

    PubMed  Google Scholar 

  35. Deckers IE, Prens EP. A update on medical treatment options for hidradenitis suppurativa. Drugs. 2016;76(2):215–29.

    Article  CAS  PubMed  Google Scholar 

  36. Yazdanyar S, et al. Dapsone therapy for hidradenitis suppurativa: a series of 24 patients. Dermatology. 2011;222(4):342–6.

    Article  CAS  PubMed  Google Scholar 

  37. Van der Zee HH, et al. Medical treatments of hidradenitis suppurativa: more options, less evidence. Dermatol Clin. 2016;34(1):91–6.

    Article  PubMed  Google Scholar 

  38. Grundmann SA, et al. Delayed pressure urticaria- dapsone heading for first-line therapy? J Dtsch Dermatol Ges. 2011;9(11):908–12.

    PubMed  Google Scholar 

  39. Noda S, et al. Long-term complete resolution of severe chronic idiopathic urticaria after dapsone treatment. J Dermatol. 2012;39(5):496–7.

    Article  PubMed  Google Scholar 

  40. Kaplan AP. Treatment of chronic spontaneous urticaria. Allergy Asthma Immunol Res. 2012;4(6):326–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Maurer M. Revisions to the international guidelines on the diagnosis and therapy of chronic urticaria. J Dtsch Dermatol Ges. 2013;11(10):971–7.

    PubMed  Google Scholar 

  42. Asero R. Current challenges and controversies in the management of chronic spontaneous urticaria. Expert Rev Clin Immunol. 2015;11(10):1073–82.

    Article  CAS  PubMed  Google Scholar 

  43. Belani H. Neutrophilic urticaria with systemic inflammation: a case series. JAMA Dermatol. 2013;149(4):453–8.

    Article  PubMed  Google Scholar 

  44. de Menthon M. Treating polyarteritis nodosa: current state of art. Clin Exp Rheumatol. 2011;29(1 Suppl 64):S110–6.

    PubMed  Google Scholar 

  45. Kundu R. Age old dapsone in the treatment of idiopathic thrombocytopenic purpura—a case report with review. Am J Ther. 2013;20(6):e723–5.

    Article  PubMed  Google Scholar 

  46. El Benaye J. Dapsone efficacy in lupus miliaris disseminates faciei: two cases. Ann Dermatol Venereol. 2011;138(8–9):597–600.

    Article  PubMed  Google Scholar 

  47. Piette EW. Dapsone in the management of autoimmune bullous diseases. Dermatol Clin. 2011;29(4):561–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Mazille N. Dapsone for chronic skin lesions in 3 children suffering from Henoch-Schonlein vasculitis. Arch Pediatr. 2011;18(11):1201–4.

    Article  CAS  PubMed  Google Scholar 

  49. Salehzadeh F. Dapsone as an alternative therapy in children with familial Mediterranean fever. Iran J Pediatr. 2012;22(1):23–7.

    PubMed  PubMed Central  Google Scholar 

  50. Marzano AV. Autoinflammatory skin disorders in inflammatory bowel diseases, pyoderma gangrenosum and Sweet’s syndrome: a comprehensive review and disease classification criteria. Clin Rev Allergy Immunol. 2013;45(2):202–10.

    Article  CAS  PubMed  Google Scholar 

  51. Ehmann LM. Successful treatment of granulomatous rosacea with dapsone. Hautarzt. 2013;64(4):226–8.

    Article  CAS  PubMed  Google Scholar 

  52. Bakkour W. Successful use of dapsone for the management of circinate balanitis. Clin Exp Dermatol. 2014;39(3):333–5.

    Article  CAS  PubMed  Google Scholar 

  53. Goeser MR, et al. A practical approach to the diagnosis, evaluation, and management of cutaneous small-vessel vasculitis. Am J Clin Dermatol. 2014;15(4):299–306.

    Article  PubMed  Google Scholar 

  54. Rabler F, et al. Treatment of eosinophilic cellulitis (wells syndrome)- a systematic review. J Eur Acad Dermatol Venereol. 2016;30(9):1465–79.

    Article  Google Scholar 

  55. Coelho de Sousa V, et al. Successful treatment of eosinophilic cellulitis with dapsone. Dermatol Online J. 2016;22(7).

    Google Scholar 

  56. Watts PJ, et al. Subcorneal pustular dermatosis: a review of 30 years of progress. Am J Clin Dermatol. 2016;17(6):653–71.

    Article  PubMed  Google Scholar 

  57. Broussard KC, et al. Erosive pustular dermatosis of the scalp: a review with a focus on dapsone therapy. J Am Acad Dermatol. 2012;66(4):680–6.

    Article  PubMed  Google Scholar 

  58. Oliveira AC, et al. Behcet disease: clinical features and management in a Brazilian tertiary hospital. J Clin Rheumatol. 2011;17(8):416–20.

    Article  PubMed  Google Scholar 

  59. Rotondo C, et al. Mucocutaneous involvement in Behcet’s disease: how systemic treatment has changed in the last decades and future perspectives. Mediators Inflamm. 2015;2015:451675.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Anjaneyan G, et al. Ofuji’s disease in an immunocompetent patient successfully treated with dapsone. Indian Dermatol Online J. 2016;7(5):399–401.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Sheu JS, et al. Dapsone therapy for pustular psoriasis: case series and review of the literature. Dermatology. 2016;232(1):97–101.

    Article  CAS  PubMed  Google Scholar 

  62. Blanco I, et al. Neutrophilic panniculitis associated with alpha-1-antitrypsin deficiency: an update. Dr J Dermatol. 2016;174(4):753–62.

    Article  CAS  Google Scholar 

  63. Akasaka E, et al. Diaminodiphenyl sulfone-induced hemolytic anemia and alopecia in a case of linear IgA bullous dermatosis. Case Rep Dermatol. 2015;7(2):183–6.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Swartzentruber GS. Metheoglobinemia as a complication of topical dapsone. N Engl J Med. 2015;372(5):491–2.

    Article  CAS  PubMed  Google Scholar 

  65. Kang KS, et al. Clinical outcomes of adverse cardiovascular events in patients with acute dapsone poisoning. Elin Exp Emerg Med. 2016;3(1):41–5.

    Article  Google Scholar 

  66. Momen SE, et al. Erythema elevatum diutinum: a review of presentation and treatment. J Eur Acad Dermatol Venereol. 2014;28(12):1594–602.

    Article  CAS  PubMed  Google Scholar 

  67. Garcia A, et al. Fulminant hepatitis linked to dapsone hypersensitivity syndrome requiring urgent living donor liver transplantation: a case report. Pediatr Transplan. 2014;18(7):E240–5.

    Article  CAS  Google Scholar 

  68. Milkova L, et al. Asymptomatic dapsone-induced agranulocytosis in a patient with chronic spontaneous urticaria. J Dtsch Dermatol Ges. 2014;12(8):717–9.

    PubMed  Google Scholar 

  69. Semira, et al. Livedo reticularis associated with dapsone therapy in a patient with chronic urticaria. Indian J Pharmacol. 2014;46(4):438–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Brabin B, et al. Dapsone therapy for malaria during pregnancy. Drug Saf. 2004;27:633–48.

    Article  CAS  PubMed  Google Scholar 

  71. Ward S, et al. Antimalarial drugs and pregnancy: safety, pharmacokinetics, and pharmacovigilance. Lancet Infect Dis. 2007;7:136–44.

    Article  CAS  PubMed  Google Scholar 

  72. Nosten F, et al. Antimalaria drugs in pregnancy: a review. Curr Drug Saf. 2006;1(1):1–15.

    Article  CAS  PubMed  Google Scholar 

  73. Raj AC, et al. Dapsone in the treatment of resistant oral erosive lichen planus: a clinical study. J Indian Aca Oral Med Radiol. 2012;24(1):20–3.

    Article  Google Scholar 

  74. Herrero-Gonzalez JE. Clinical guidelines for the diagnosis and treatment of dermatitis herpetiformis. Actas Dermosifiliogr. 2010;101(10):820–6.

    Article  CAS  PubMed  Google Scholar 

  75. Alison R, Rupali J. Dapsone interferes with hemoglobin A1c monitoring of diabetes in an HIV-infected patient. AIDS. 2013;27:299–301.

    Article  Google Scholar 

  76. Phillips-Howard PA, et al. Serious adverse drug reactions to pyrimethamine-sulphadoxine, pyrimethamine-dapsone and to amodiaquine in Britain. J R Soc Med. 1990;83:82–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Gottfried W, Christian B. Dapsone in dermatology and beyond. Arch Dermatol Res. 2014;306(2):103–24.

    Article  Google Scholar 

  78. Cohen PR, et al. Sweet’s syndrome: a review of current treatment options. Am J Clin Dermatol. 2002;3(2):177–31.

    Article  Google Scholar 

  79. http://www.glutenfreedrugs.com/newlist.htm. Accessed 23 March 2017.

Download references

Author information

Authors and Affiliations

  1. Baylor University Medical Center, The University of Texas Southwestern Medical School, Dallas, Texas, USA

    William Abramovits MD, FAAD

Authors
  1. William Abramovits MD, FAAD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William Abramovits MD, FAAD .

Editor information

Editors and Affiliations

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

    Paul S. Yamauchi

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Abramovits, W. (2018). Dapsone in Dermatology. In: Yamauchi, P. (eds) Biologic and Systemic Agents in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-66884-0_44

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-66884-0_44

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66883-3

  • Online ISBN: 978-3-319-66884-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation