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Year : 1995  |  Volume : 61  |  Issue : 6  |  Page : 385-386

Erythema annulare centrifugum responding to dapsone

Correspondence Address:
Rajesh Sankar

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Source of Support: None, Conflict of Interest: None

PMID: 20953039

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How to cite this article:
Sankar R. Erythema annulare centrifugum responding to dapsone. Indian J Dermatol Venereol Leprol 1995;61:385-6

How to cite this URL:
Sankar R. Erythema annulare centrifugum responding to dapsone. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Aug 21];61:385-6. Available from: http://www.ijdvl.com/text.asp?1995/61/6/385/4290

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A 47-year-old male reported with a mildly pruritic skin lesion over the right forearm of 2 weeks' duration. The lesion was an annular erythematous plaque, of about 2.5 cm in diameter, and had a raised border. Topical antifungals, and later topical steroids were given. After an initial response to topical clobetasol propionate 0.05%, the lesion started progressing and extending. New lesions with an annular configuration started appearing proximal to the initial lesion. The plaque was then biopsied and subjected to histopathological examination. The epidermis showed irregular atrophy with spongiosis and focal parakeratosis. There was a sharply demarcated perivascular infiltrate of lymphocytes in the dermis. Based on the histopathological diagnosis of Erythema Annulare Centrifugum, topical steroids (betamethasone dipropionate 0.05%) was continued, but with no effect. The lesions started involving the upper arm and shoulder. At this juncture, dapsone, 100 mg twice daily, was introduced, alongwith topical application of an emollient cream. The patient responded dramatically with almost complete resolution of all the lesions, including the primary one, within a week. Dapsone was then continued, in the same dose for another week, and then tapered to 100 mg once daily, and stopped after a fortnight. After complete resolution, the patient has not had any recurrence of lesions.

Daspone has found useful in a wide variety of inflammatory cutaneous disorders viz., vesiculobullous disorders, vasculitides, pustular psoriasis, and the like.[1] However, despite reports of its efficacy in Erythema elevatum diutinum,[2] and Granuloma annulare,[3] its use in the treatment of Erythema Annulare Centrifugum has not been documented. Dapsone is purported to have a suppressor action on polymorphonuclear leucocytes, inhibits mitogen stimulated lymphocyte transformation, and also has effects on membrane associated phospholipid metabolism, lysosomal enzymes, and tissue proteinases, but the specific mechanism of action of dapsone, and how it affects a wide variety of dermatological diseases, are unknown.

  References Top

1.Greer KA. Dapsone and sulfapyridine. In: Systemic Drugs for Skin Diseases (SE Wolverton, JK Wilkin, eds) 1st edn. W B Saunders Company, 1992;247-63  Back to cited text no. 1    
2.Fort SL, Rodman OG. Erythema elevatum diutinum response to dapsone. Arch Dermatol 1977;113:819-22.  Back to cited text no. 2  [PUBMED]  
3.Saied N, Schwartz RA, Estes SA. Treatment of Generalised Granuloma Annulare with Dapsone. Arch Dermatol 1980;116:1345-6  Back to cited text no. 3  [PUBMED]  


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