Authors
1 Departments of Dermatology, Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Departments of Dermatology, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Acne vulgaris, a common human skin condition, is an inflammatory disease characterized by comedones, papules, nodules and possibly scarring.
This study aimed to evaluate the efficacy of a combination of 5% dapsone gel plus oral isotretinoin in the treatment of acne vulgaris.
Materials and Methods: A randomized, placebo-controlled, study was carried out on patients with moderate to severe acne. The patients were randomly divided in two groups: (dapsone gel and vehicle gel). All Patients were administered oral isotretinoin 20 mg daily and topical gel twice a day for 8 weeks. The Global Acne Assessment Score (GAAS), the number lesions and side-effects were documented at base line and weeks 4, 8 and 12.
Results: A total of 58 patients (age range: 18-25 years) were included in our study. The number of lesions was significantly lower in the dapsone-treated group at all follow-up visits (P < 0.001). The mean GAAS score in the dapsone-treated group and in the Placebo-treated group decreased, but there was no statistical difference in two groups (P < 0.001). The side-effects on the dapsone-treated group were a mild burning sensation in 7 patients (24.13%), mild erythema of the skin and mild dryness in 4 (13.79%) and 3 (10.34%) cases respectively (P < 0.001). In our study, adverse effects were common but they were minor and tolerable. No clinically significant changes in laboratory parameters were observed (P < 0.001).
Conclusions: Dapsone gel was an effective medication for patients who received isotretinoin for acne vulgaris treatment resulting in a significant reduction of the number of lesions.
Keywords
1. | Hsu P, Litman GI, Brodell RT. Overview of the treatment of acne vulgaris with topical retinoids. Postgrad Med 2011;123:153-61. |
2. | Kraft J, Freiman A. Management of acne. CMAJ 2011;183:E430-5. |
3. | Tanghetti EA. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol 2013;6:27-35. |
4. | Dhir R, Gehi NP, Agarwal R, More YE. Oral isotretinoin is as effective as a combination of oral isotretinoin and topical anti-acne agents in nodulocystic acne. Indian J Dermatol Venereol Leprol 2008;74:187. |
5. | Sago J, Hall RP. Dapsone. Dermatol Ther 2002;15:340-51. |
6. | Scheinfeld N. Aczone, a topical gel formulation of the antibacterial, anti-inflammatory dapsone for the treatment of acne. Curr Opin Investig Drugs 2009;10:474-81. |
7. | Paniker U, Levine N. Dapsone and sulfapyridine. Dermatol Clin 2001;19:79-86, viii. |
8. | Pickert A, Raimer S. An evaluation of dapsone gel 5% in the treatment of acne vulgaris. Expert Opin Pharmacother 2009;10:1515-21. |
9. | Schlessinger J, Menter A, Gold M, Leonardi C, Eichenfield L, Plott RT, et al. Clinical safety and efficacy studies of a novel formulation combining 1.2% clindamycin phosphate and 0.025% tretinoin for the treatment of acne vulgaris. J Drugs Dermatol 2007;6:607-15. |
10. | 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;11:1417-21. |
11. | Draelos ZD, Carter E, Maloney JM, Elewski B, Poulin Y, Lynde C, et al. Two randomized studies demonstrate the efficacy and safety of dapsone gel, 5% for the treatment of acne vulgaris. J Am Acad Dermatol 2007;56:439.e1-10. |
12. | Kircik LH. Harnessing the anti-inflammatory effects of topical dapsone for management of acne. J Drugs Dermatol 2010;9:667-71. |
13. | Booth SA, Moody CE, Dahl MV, Herron MJ, Nelson RD. Dapsone suppresses integrin-mediated neutrophil adherence function. J Invest Dermatol 1992;98:135-40. |
14. | Debol SM, Herron MJ, Nelson RD. Anti-inflammatory action of dapsone: Inhibition of neutrophil adherence is associated with inhibition of chemoattractant-induced signal transduction. J Leukoc Biol 1997;62:827-36. |