Mepacrine as successful monotherapy for refractory Jessner-Kanof disease: still an important drug in the dermatologic armamentarium.

Abstract

INTRODUCTION:

Jessner-Kanof disease (JKD), a lymphocytic infiltration of the skin, can be difficult to treat. Mepacrine (quinacrine), an anti-malarial less available in Belgium, may be beneficial.

PATIENTS AND METHODS:

Two female patients with biopsy-proven and therapy-resistant JKD, not responding to topical and systemic corticosteroids, (hydroxy-)chloroquine and/or dapsone, were treated with mepacrine 100 mg daily.

RESULTS:

In both patients an amelioration was observed during the first month of treatment, and clinical remission was obtained by the fourth month, without any side-effects. In both cases, the dose could be tapered to three times weekly.

DISCUSSION:

JKD is strongly related to lupus erythematosus (tumidus), and although spontaneous remissions may occur, it is notoriously difficult to treat. Mepacrine may be initiated as an add-on therapy to (hydroxy-)chloroquine, but also as monotherapy. A dose of 100 mg a day, tapered to weekly doses once remission is obtained, seems feasible. Except for (mild) yellow skin discoloration, the drug has few side-effects, and offers the advantage of not displaying retinal toxicity.

CONCLUSION:

Mepacrine is still a useful and safe drug for treating cutaneous lupus erythematosus and related skin conditions, such as refractory JKD in particular. Its future availability, also in Belgium, is therefore important.

• Authors: Laura Wuyts, Julie Dandelooy, Vasiliki Siozopolou, Julien Lambert, Olivier Aerts
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 28 Issue 3 Pg. 276-278 (May 2017) ISSN: 1471-1753 [Electronic] England
• PMID: 27686749 (Publication Type: Case Reports, Journal Article)

Chemical References

• Enzyme Inhibitors
• Quinacrine

Topics

• Adult
• Enzyme Inhibitors (therapeutic use)
• Epidermis (pathology)
• Female
• Fluorescent Antibody Technique, Direct
• Humans
• Lupus Erythematosus, Cutaneous (drug therapy)
• Middle Aged
• Quinacrine (therapeutic use)