Therapy of noninfectious granulomatous skin diseases with fumaric acid esters.

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.

• Authors: K Breuer, R Gutzmer, B Völker, A Kapp, T Werfel
• Journal: The British journal of dermatology (Br J Dermatol) Vol. 152 Issue 6 Pg. 1290-5 (Jun 2005) ISSN: 0007-0963 [Print] England
• PMID: 15948995 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Esters
• Fumarates
• fumaric acid

Topics

• Adolescent
• Adult
• Aged
• Cheilitis (drug therapy)
• Drug Administration Schedule
• Esters
• Female
• Fumarates (administration & dosage, therapeutic use)
• Granuloma Annulare (drug therapy)
• Granuloma, Giant Cell (drug therapy)
• Humans
• Male
• Middle Aged
• Necrobiosis Lipoidica (drug therapy)
• Retrospective Studies
• Sarcoidosis (drug therapy)
• Skin Diseases (drug therapy)