Therapy of noninfectious granulomatous skin diseases with fumaric acid esters
Identifieur interne : 001E27 ( Main/Exploration ); précédent : 001E26; suivant : 001E28Therapy of noninfectious granulomatous skin diseases with fumaric acid esters
Auteurs : K. Breuer [Allemagne] ; R. Gutzmer [Allemagne] ; B. Völker [Allemagne] ; A. Kapp [Allemagne] ; T. Werfel [Allemagne]Source :
- British Journal of Dermatology [ 0007-0963 ] ; 2005-06.
English descriptors
- Teeft :
- Acad dermatol, Adverse events, Allopurinol, Annular, Annular elastolytic giant cell granuloma, Annulare, Arch dermatol, Breuer, British association, Complete clearance, Corticosteroid, Cutaneous, Cutaneous sarcoidosis, Cytokine, Dermatol, Dermatologists british journal, Dermatology, Discontinuation, Elastolytic, Ester, Fumaderm, Fumaric, Fumaric acid esters, Generalized granuloma annulare, Granuloma, Granuloma annulare, Granulomatous, Granulomatous cheilitis, Granulomatous skin disease, Granulomatous skin diseases, Laboratory changes, Lesion, Lipoidica, Lung function, Moderate improvement, Necrobiosis, Necrobiosis lipoidica, Noninfectious granulomatous skin diseases, Psoriasis, Pulmonary stage, Puva, Sarcoidosis, Skin lesions, Successful treatment, Systemic sarcoidosis, Topical corticosteroids, Total leucocyte count, Treatment duration.
Abstract
Background Noninfectious granulomatous skin diseases are inflammatory disorders of unknown aetiology which are often recalcitrant to common anti‐inflammatory treatment regimens. Recently, in several case reports, fumaric acid esters (FAE) have proved beneficial in granulomatous skin diseases, but studies on a larger collection of consecutive patients have not yet been performed. Objectives To investigate the therapeutic efficacy of FAE for the treatment of granulomatous skin diseases. Patients and methods The therapeutic efficacy and side‐effects of FAE were analysed retrospectively in 32 patients with disseminated granuloma annulare (n = 13), annular elastolytic giant cell granuloma (n = 3), sarcoidosis (n = 11), necrobiosis lipoidica (n = 4), or granulomatous cheilitis (n = 1). Results Three patients discontinued treatment within 4 weeks because of side‐effects. Of the remaining 29 patients, 18 patients responded to treatment with FAE. Marked improvement or complete clearance was seen in seven patients. We observed a slight to moderate improvement in 11 patients, and 11 patients did not respond. In patients showing a complete remission, the maximum effect was observed after 8·5 months (SD ±6 months, range 3–20 months). In two patients with systemic sarcoidosis, the pulmonary changes improved in parallel with the skin. Side‐effects were usually mild and resolved spontaneously upon dose reduction or discontinuation of the therapy. Conclusions The data presented here indicate that FAE may be considered for the treatment of recalcitrant granulomatous skin disease.
Url:
DOI: 10.1111/j.1365-2133.2005.06585.x
Affiliations:
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Völker</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology and Allergology, Hannover Medical University, Ricklinger Strasse 5, 30449 Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Kapp, A" sort="Kapp, A" uniqKey="Kapp A" first="A." last="Kapp">A. Kapp</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology and Allergology, Hannover Medical University, Ricklinger Strasse 5, 30449 Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Werfel, T" sort="Werfel, T" uniqKey="Werfel T" first="T." last="Werfel">T. Werfel</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology and Allergology, Hannover Medical University, Ricklinger Strasse 5, 30449 Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">British Journal of Dermatology</title><title level="j" type="alt">BRITISH JOURNAL OF DERMATOLOGY</title><idno type="ISSN">0007-0963</idno><idno type="eISSN">1365-2133</idno><imprint><biblScope unit="vol">152</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1290">1290</biblScope><biblScope unit="page" to="1295">1295</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Science Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2005-06">2005-06</date></imprint><idno type="ISSN">0007-0963</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0007-0963</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Acad dermatol</term><term>Adverse events</term><term>Allopurinol</term><term>Annular</term><term>Annular elastolytic giant cell granuloma</term><term>Annulare</term><term>Arch dermatol</term><term>Breuer</term><term>British association</term><term>Complete clearance</term><term>Corticosteroid</term><term>Cutaneous</term><term>Cutaneous sarcoidosis</term><term>Cytokine</term><term>Dermatol</term><term>Dermatologists british journal</term><term>Dermatology</term><term>Discontinuation</term><term>Elastolytic</term><term>Ester</term><term>Fumaderm</term><term>Fumaric</term><term>Fumaric acid esters</term><term>Generalized granuloma annulare</term><term>Granuloma</term><term>Granuloma annulare</term><term>Granulomatous</term><term>Granulomatous cheilitis</term><term>Granulomatous skin disease</term><term>Granulomatous skin diseases</term><term>Laboratory changes</term><term>Lesion</term><term>Lipoidica</term><term>Lung function</term><term>Moderate improvement</term><term>Necrobiosis</term><term>Necrobiosis lipoidica</term><term>Noninfectious granulomatous skin diseases</term><term>Psoriasis</term><term>Pulmonary stage</term><term>Puva</term><term>Sarcoidosis</term><term>Skin lesions</term><term>Successful treatment</term><term>Systemic sarcoidosis</term><term>Topical corticosteroids</term><term>Total leucocyte count</term><term>Treatment duration</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Noninfectious granulomatous skin diseases are inflammatory disorders of unknown aetiology which are often recalcitrant to common anti‐inflammatory treatment regimens. Recently, in several case reports, fumaric acid esters (FAE) have proved beneficial in granulomatous skin diseases, but studies on a larger collection of consecutive patients have not yet been performed. Objectives To investigate the therapeutic efficacy of FAE for the treatment of granulomatous skin diseases. Patients and methods The therapeutic efficacy and side‐effects of FAE were analysed retrospectively in 32 patients with disseminated granuloma annulare (n = 13), annular elastolytic giant cell granuloma (n = 3), sarcoidosis (n = 11), necrobiosis lipoidica (n = 4), or granulomatous cheilitis (n = 1). Results Three patients discontinued treatment within 4 weeks because of side‐effects. Of the remaining 29 patients, 18 patients responded to treatment with FAE. Marked improvement or complete clearance was seen in seven patients. We observed a slight to moderate improvement in 11 patients, and 11 patients did not respond. In patients showing a complete remission, the maximum effect was observed after 8·5 months (SD ±6 months, range 3–20 months). In two patients with systemic sarcoidosis, the pulmonary changes improved in parallel with the skin. Side‐effects were usually mild and resolved spontaneously upon dose reduction or discontinuation of the therapy. Conclusions The data presented here indicate that FAE may be considered for the treatment of recalcitrant granulomatous skin disease.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Basse-Saxe</li></region><settlement><li>Hanovre</li></settlement></list><tree><country name="Allemagne"><region name="Basse-Saxe"><name sortKey="Breuer, K" sort="Breuer, K" uniqKey="Breuer K" first="K." last="Breuer">K. Breuer</name></region><name sortKey="Gutzmer, R" sort="Gutzmer, R" uniqKey="Gutzmer R" first="R." last="Gutzmer">R. Gutzmer</name><name sortKey="Kapp, A" sort="Kapp, A" uniqKey="Kapp A" first="A." last="Kapp">A. Kapp</name><name sortKey="Volker, B" sort="Volker, B" uniqKey="Volker B" first="B." last="Völker">B. Völker</name><name sortKey="Werfel, T" sort="Werfel, T" uniqKey="Werfel T" first="T." last="Werfel">T. Werfel</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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