Dapsone shows long-term positive outcomes in patients with hidradenitis suppurativa

Dapsone is a potential and well-tolerated long-term Hidradenitis suppurativa (HS) therapy option, and it was primarily chosen for individuals with the LC2 phenotype in this study, says an article published in Dermatologic Therapy.

HS is a chronic inflammatory condition that is difficult to treat. Dapsone is now reserved as a third-line treatment for individuals with mild to moderate HS, according to current recommendations. Only four tiny case series have been documented as far as we know. This study was conducted by Cristina López-Llunell and team with the goal to see how successful and safe dapsone was in the therapeutic practice.

A retrospective observational single-center study was conducted on 56 HS patients who received dapsone medication between May 1, 2015, and June 1, 2021. The response to treatment was measured using the Hidradenitis Suppurativa Clinical Response (HiSCR) scale.

The key findings of this study are as follow:

1. There were 56 patients in total, with a median age of 33 years and 66% of them being men.

2. The majority of them were LC2 follicular phenotypic patients with mild to severe illness.

3. All of the patients had previously failed to respond to first-line therapies.

4. Dapsone was administered in doses ranging from 50 to 150 mg per day.

5. After 12 weeks of treatment, 62.5% of the patients had attained HiSCR.

6. There were no major side effects discovered.

7. Treatment lasted an average of 8 months.

8. A link was discovered after multivariate analysis between the existence of fistulous tracts and the chance of non-response to the drug.

9. Oral retinoids were given to four of the dapsone responders in order to achieve a long-term response.

10. The study's limitations include its retrospective and non-controlled character.

In conclusion, on mild and moderate HS, dapsone is an efficient and well-tolerated therapy. This medication is ineffective in severe Hurley III patients with a prevalence of sinus tracts and the LC1 phenotype.

Reference:

López-Llunell, C, Riera-Martí, N, Gamissans, M, Romaní, J. Dapsone in hidradenitis suppurativa: A case series of 56 patients. Dermatologic Therapy. 2021; 34( 6):e15161. doi:10.1111/dth.15161