Efficacy of Topical Dapsone 5% Gel for the Treatment of Erythematotelangiectatic Rosacea: New Treatment Option with Old Drug

Efficacy of Topical Dapsone 5% Gel for the Treatment of Erythematotelangiectatic Rosacea: New Treatment Option with Old Drug

Authors

  • Şule Gökşin Pamukkale University Medical Faculty, Dermatology Department, Denizli, Turkey
  • Işıl Göğem İmren Denizli State Hospital, Dermatology Department, Denizli, Turkey
  • Nida Kaçar Pamukkale University Medical Faculty, Dermatology Department, Denizli, Turkey

Keywords:

dapsone gel, treatment, adverse events, erythematotelangiectatic rosacea

Abstract

Introduction: Many topical drugs are used in the treatment of erythematotelangiectatic rosacea (ETR). However, dapsone 5% gel has never been used in ETR to date.

Objectives: To evaluate the efficacy of dapsone 5% gel as a new treatment option for ETR.

Methods: Thirty-five patients with ETR were included in the study. Diagnosis was made with National Rosacea Society criteria. Dapsone 5% gel was used topically twice a day for 12 weeks. Investigator Global Assessment (IGA) 4-point scale ( 0 → Clean, 1 → mild, 2 → moderate, 3 → severe, 4 → very severe), Visual Analogue Scale (VAS) and Dermatology Life Quality Index (DLQI) were used for evaluation (at baseline, 2nd, 6th, and 12th weeks).

Results: IGA scores among baseline (2 → 62.9%, 3 → 34.3%, 4 → 2.9%) and 2nd (1 → 14.3%, 2 → 77,1%, 3 → 8.6%), 6th (1 → 45,7%, 2 → 54.3%) and 12th weeks (1 → 62.9%, 2 → 37.1%) were found to be statistically significant (P < 0.001). Median VAS scores among baseline (median = 7 [5-9]) and 2nd (median=5 [3-8]), 6th (median=5 [3-6]) and 12th weeks (median = 4 [2-6]) were statistically significant (P < 0.001). Median DLQI scores among baseline (median = 8 [6-14]) and 2nd (median = 5 [3-11]), 6th (median = 5 [3-11]) and 12th weeks (median = 4 [2-9]) were statistically significant (p<0.001). Concurrent systemic disease was a risk factor for poor treatment response (P = 0.034). Mild irritation was observed in 3 patients (8.5%) during treatment.

Conclusions: Dapsone 5% gel was effective and well tolerated in ETR treatment.

References

Lee HJ, Hong YJ, Kim M. Angiogenesis in Chronic Inflammatory Skin Disorders. Int J Mol Sci. 2021;22(21):12035. DOI: 10.3390/ijms222112035. PMID: 34769465. PMCID: PMC8584589.

Dall'Oglio F, Nasca MR, Micali G. Emerging topical drugs for the treatment of rosacea. Expert Opin Emerg Drugs. 2021;26(1):27-38. DOI: 10.1080/14728214.2021.1887138. PMID: 33596752.

Abokwidir M, Feldman SR. Rosacea Management. Skin Appendage Disord. 2016;2(1-2):26-34. DOI: 10.1159/000446215. PMID: 27843919. PMCID: PMC5096126.

Lim HS, Lee SC, Won YH, Lee JB. The efficacy of intense pulsed light for treating erythematotelangiectatic rosacea is related to severity and age. Ann Dermatol. 2014;26(4):491-495. DOI: 10.5021/ad.2014.26.4.491. PMID: 25143679. PMCID: PMC4135105.

Micali G, Gerber PA, Lacarrubba F, Schäfer G. Improving Treatment of Erythematotelangiectatic Rosacea with Laser and/or Topical Therapy Through Enhanced Discrimination of its Clinical Features. J Clin Aesthet Dermatol. 2016;9(7):30-39. PMID: 27672409. PMCID: PMC5023001.

Buddenkotte J, Steinhoff M. Recent advances in understanding and managing rosacea. F1000Res. 2018;7:F1000 Faculty Rev-1885. DOI: 10.12688/f1000research.16537.1. PMID: 30631431. PMCID: PMC6281021.

Brown LF, Detmar M, Claffey K, et al. Vascular permeability factor/vascular endothelial growth factor: a multifunctional angiogenic cytokine. EXS. 1997;79:233-69. DOI: 10.1007/978-3-0348-9006-9_10. PMID: 9002222.

Kwon MJ, Joo HG. Dapsone modulates lipopolysaccharide-activated bone marrow cells by inducing cell death and down-regulating tumor necrosis factor-α production. J Vet Sci. 2018;19(6):744-749. DOI: 10.4142/jvs.2018.19.6.744. PMID: 30304888. PMCID: PMC6265590.

Kanwar B, Khattak A, Kast RE. Dapsone Lowers Neutrophil to Lymphocyte Ratio and Mortality in COVID-19 Patients Admitted to the ICU. Int J Mol Sci. 2022;23(24):15563. DOI: 10.3390/ijms232415563. PMID: 36555204. PMCID: PMC9779021.

Wilkin J, Dahl M, Detmar M, et al. National Rosacea Society Expert Committee. Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol. 2004;50(6):907-912. DOI: 10.1016/j.jaad.2004.01.048. PMID: 15153893.

Schaller M, Kemény L, Havlickova B, et al. A randomized phase 3b/4 study to evaluate concomitant use of topical ivermectin 1% cream and doxycycline 40-mg modified-release capsules, versus topical ivermectin 1% cream and placebo in the treatment of severe rosacea. J Am Acad Dermatol. 2020;82(2):336-343. DOI: 10.1016/j.jaad.2019.05.063. PMID: 31150711.

Iskandarli M, Ertam İ, Ünal İ. Impact of intense pulse light on quality of life in patients with erythematotelangiectatic rosacea. Turkderm-Turk Arch Dermatol Venereology 2017;51:46-51. DOI: 10.4274/turkderm.69008.

Schaller M, Dirschka T, Kemény L, Briantais P, Jacovella J. Superior Efficacy with Ivermectin 1% Cream Compared to Metronidazole 0.75% Cream Contributes to a Better Quality of Life in Patients with Severe Papulopustular Rosacea: A Subanalysis of the Randomized, Investigator-Blinded ATTRACT Study. Dermatol Ther (Heidelb). 2016;6(3):427-436. DOI: 10.1007/s13555-016-0133-6. PMID: 27432169. PMCID: PMC4972739.

Abram K, Silm H, Maaroos HI, Oona M. Subjective disease perception and symptoms of depression in relation to healthcare-seeking behaviour in patients with rosacea. Acta Derm Venereol. 2009;89(5):488-491. DOI: 10.2340/00015555-0716. PMID: 19734974.

Dermatology Life Quality Index. Cardiff University, School of Medicine. Accessed June 10, 2023. Available from: https://www.cardiff.ac.uk/medicine/resources/quality-of-life-questionnaires/dermatology-life-quality-index.

Zhang H, Tang K, Wang Y, Fang R, Sun Q. Rosacea Treatment: Review and Update. Dermatol Ther (Heidelb). 2021;11(1):13-24. DOI: 10.1007/s13555-020-00461-0. PMID: 33170491. PMCID: PMC7858727.

Anderson MS, Nadkarni A, Cardwell LA, Alinia H, Feldman SR. Spotlight on brimonidine topical gel 0.33% for facial erythema of rosacea: safety, efficacy, and patient acceptability. Patient Prefer Adherence. 2017;11:1143-1150. DOI: 10.2147/PPA.S115708. PMID: 28740369. PMCID: PMC5505675.

Oge' LK, Muncie HL, Phillips-Savoy AR. Rosacea: Diagnosis and Treatment. Am Fam Physician. 2015;92(3):187-196. PMID: 26280139.

van Zuuren EJ, Arents BWM, van der Linden MMD, Vermeulen S, Fedorowicz Z, Tan J. Rosacea: New Concepts in Classification and Treatment. Am J Clin Dermatol. 2021;22(4):457-465. DOI: 10.1007/s40257-021-00595-7. PMID: 33759078. PMCID: PMC8200341.

Fowler JF Jr. Combined effect of anti-inflammatory dose doxycycline (40-mg doxycycline, usp monohydrate controlled-release capsules) and metronidazole topical gel 1% in the treatment of rosacea. J Drugs Dermatol. 2007;6:641–645.

Sanchez J, Somolinos AL, Almodóvar PI, et al. A randomized, double-blind, placebo-controlled trial of the combined effect of doxycycline hyclate 20-mg tablets and metronidazole 0.75% topical lotion in the treatment of rosacea. J Am Acad Dermatol. 2005;53:791–797.

Leyden JJ. Randomized, phase 2, dose-ranging study in the treatment of rosacea with encapsulated benzoyl peroxide gel. J Drugs Dermatol. 2014;13:685–688.

Sodha P, Suggs A, Munavalli GS, Friedman PM. A Randomized Controlled Pilot Study: Combined 595-nm Pulsed Dye Laser Treatment and Oxymetazoline Hydrochloride Topical Cream Superior to Oxymetazoline Hydrochloride Cream for Erythematotelangiectatic Rosacea. Lasers Surg Med. 2021;53(10):1307-1315. DOI: 10.1002/lsm.23439. PMID: 34233378. PMCID: PMC9290736.

Wang X, Wang Z, Sun L, Liu H, Zhang F. Efficacy and safety of dapsone gel for acne: a systematic review and meta-analysis. Ann Palliat Med. 2022;11(2):611-620. DOI: 10.21037/apm-21-3935. PMID: 35249339.

Rainer BM, Kang S, Chien AL. Rosacea: Epidemiology, pathogenesis, and treatment. Dermatoendocrinol. 2017;9(1):e1361574. DOI: 10.1080/19381980.2017.1361574. PMID: 29484096. PMCID: PMC5821167.

Lowe E, Lim S. Paradoxical Erythema Reaction of Long-term Topical Brimonidine Gel for the Treatment of Facial Erythema of Rosacea. J Drugs Dermatol. 2016;15(6):763-765. PMID: 27272086.

Cookson H, McFadden J, White J, White IR. Allergic contact dermatitis caused by Mirvaso®, brimonidine tartrate gel 0.33%, a new topical treatment for rosaceal erythema. Contact Dermatitis. 2015;73(6):366-377. DOI: 10.1111/cod.12476. PMID: 26768997.

Routt ET, Levitt JO. Rebound erythema and burning sensation from a new topical brimonidine tartrate gel 0.33%. J Am Acad Dermatol. 2014;70(2):e37-e38. DOI: 10.1016/j.jaad.2013.10.054. PMID: 24438976.

Faghihi G, Khosravani P, Nilforoushzadeh MA, et al. Dapsone Gel in the Treatment of Papulopustular Rosacea: A Double-Blind Randomized Clinical Trial. J Drugs Dermatol. 2015;14(6):602-606. PMID: 26091386.

Downloads

Published

2024-01-31

Issue

Section

Original Article

How to Cite

1.
Efficacy of Topical Dapsone 5% Gel for the Treatment of Erythematotelangiectatic Rosacea: New Treatment Option with Old Drug. Dermatol Pract Concept [Internet]. 2024 Jan. 31 [cited 2024 Jul. 13];14(1):e2024034. Available from: https://dpcj.org/index.php/dpc/article/view/3629

Share