Variable responsiveness of generalized pustular psoriasis to treatment with dapsone and colchicine: report of 2 cases

Hammami, Hatem and Jaber, Kahena and Yousseff, S. and Raouf Dhaoui, M. and Doss, Néjib (2009) Variable responsiveness of generalized pustular psoriasis to treatment with dapsone and colchicine: report of 2 cases. Dermatologia clinica , 29 (1). pp. 38-40. ISSN 2037-6685

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We attempt to critically review the relevant information on currently available unapproved indications of dapsone and colchicine in pustular psoriasis. Observations Case 1: a 66-year-old woman had a 12 years history of pustular psoriasis. She had responded well to methotrexate treatment until we reach a cumulative dose of 1.48 g. A trial of dapsone was started for a new attack of her disease. The patient recovered after 2 weeks then she presented a relapse and a drop in hemoglobin level. Dapsone was stopped and we prescribed colchicine with good response. One month later, a new attack occurred. Case 2: a 38-year-old man had severe generalized pustular psoriasis of 28 years’ duration. Treatment modalities including acitretin methotrexate were applied, but induced short remissions. We try dapsone. At the third week, the patient did not show any significant clinical improvement. Afterwards, he was pyrexial, with red, painful, inflamed skin studded with monomorphic, sterile pustules. We stopped dapsone and prescribed acitretin at 25 mg/day and the lesions were cleared after 2 weeks. Discussion. Our present observations indicate that dapsone is not an effective and well-tolerated therapeutic option for patients with pustular psoriasis and that the effectiveness of colchicine is variable. A larger cohort with study design would be needed to draw further conclusions.

Item Type: Article
Uncontrolled Keywords: Postular psoriasis, colchicine, dapsone
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) > 616.5 Malattie del tegumento, dei peli, delle unghie
Depositing User: Matteo Viola
Date Deposited: 19 Mar 2013 10:10
Last Modified: 10 May 2013 13:17

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