A Case of Erythema Elevatum Diutinum With Pancytopenia: Focus on Dapsone-Induced Hematologic Side Effects and Colchicine as a Safe Treatment Option

October 2015 | Volume 14 | Issue 10 | Editorials | 1090 | Copyright © October 2015

Emek Kocatürk MD, Bachar Memet MD,
Ilteris Oguz Topal MD, Tülin Yüksel MD,
Pelin Kuteyla Ülkümen MD, Utkan Kızıltaç MD

Emek Kocatürk Okmeydanı Training and Research Hospital Department of Dermatology, Istanbul, Turkey

red cell aplasia (PRCA) coincident with dapsone therapy. He was given dapsone 100 mg per day. Four weeks after the start of this therapy, the patient presented with asthenia. A diagnosis of PRCA was made based off of hematological counts. Dapsone was discontinued, and the patient received blood transfusions until his condition improved considerably. Hematological counts gradually returned to normal levels.12
Corticosteroids have also been effective in patients with EED. Topical betamethasone and topical fluocinolone acetonide have been used under occlusion with good effect. In other patients both intralesional and systemic corticosteroids (prednisolone 30–40 mg daily) have produced favorable responses.9
Sulfonamides (sulfamethoxypyridazine 500 mg once daily and sulfapyridine 0.5–1 g three times daily), nicotinamide 100 mg three times daily, colchicine 0.5 mg twice daily with 0.5 mg three times daily for 3 to 4 days to abate minor disease flares, and chloroquine 300 mg daily have produced resolution of lesions. 9
Treatment of EED is difficult because this disorder follows a chronic and recurrent course.13 Recurrence rate of EED is still high if the underlying triggering factors are not under control. In our case, the patient treated with colchicine 0.5 mg twice daily. Significant improvement was observed in 6 months. Although it is ultimately the first option, it can not be used in patients with hematological problems, colchicine should be considered as a good and safe option in those patients.

DISCLOSURES

The authors have no conflict of interest to declare.

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