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DI-076 Effectiveness and tolerance of dapsone in linear IGA dermatosis in paediatric patients
  1. C Villanueva Bueno1,
  2. MI Sierra Torres2,
  3. E Montecatine Alonso2,
  4. A Rodriguez Perez2,
  5. LL Poyatos Ruiz2,
  6. C Alvarez Del Vayo Benito2
  1. 1Hospital Universitario Virgen Del Rocio, Sevilla, Spain
  2. 2Hospital Universitario Virgen Del Rocio, Pharmacy, Sevilla, Spain

Abstract

Background Linear IgA dermatosis of children (LAD) is a rare autoimmune vesiculoampollar disease described in the literature by a series of cases. Dapsone is one of the treatments used due to its anti-inflammatory action and capacity to reduce adhesion of neutrophils to IgA antibodies fixed in the membrane.

Purpose To evaluate the effectiveness and tolerance of the use of dapsone for LAD in paediatric patients.

Material and methods Retrospective, descriptive and observational study from October 2014 to October 2015. Data from patients treated with dapsone for LAD were obtained by medical record review. The variables were age, dosage, adverse reactions, size of lesions and appearance of new ones.

The effectiveness of the dose was studied based on the presence or absence of new lesions and the size of the blisters. The degree of tolerance was determined based on the occurrence of adverse effects associated with the use of dapsone.

Results Two patients aged 1 and 5 years were treated with dapsone for LAD. After corticosteroids were administrated without the desired result, dapsone was prepared as a magistral formulation. The dose range administrated per patient was 1–1.5 mg/kg/day. One of the patients picked up the preparation in the hospital pharmacy (2 mg/ml) and the other picked up it in the district pharmacy (6.25 mg/ml). There was a clear clinical improvement with a decrease in the size of the blisters. Although the patients had no significant changes in blood count, the principal adverse reaction was insomnia approximately 2.5 months after the start of therapy. Insomnia was more common in the patient who picked up the formulation in the district. In both cases sleep disturbances disappeared when the children received the formulation with an uneven distribution of dose throughout the day (higher dose in the morning and lowest at night).

Conclusion Dapsone is an effective treatment for LAD based on the good clinical response of the patients, absence of new lesions and reduction of pre-existing ones. Despite its initial poor tolerance, a dosage properly distributed throughout the day eliminated the inconvenience. New studies are required to check the variability in tolerance shown by different formulations.

No conflict of interest.

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