Successful Treatment of Perniosis With Hydroxychloroquine

Background: The current medical therapies for perniosis are diverse. The agents used have produced variable results and lack evidence-based data. Objective: To determine outcomes of patients with perniosis treated with hydroxychloroquine. Methods: In this retrospective study, patients with a diagnosis of perniosis treated with hydroxychloroquine were analyzed for dosage required, subjective improvement in signs and symptoms, and adverse drug reactions. Results: Hydroxychloroquine resulted in improvement of symptoms in four of five patients. Review of the literature has revealed 12 out of 51 cases have responded to hydroxychloroquine alone or in combination with other therapies. Conclusion: Hydroxychloroquine is a relatively safe, well tolerated alternative therapy for the treatment of perniosis and should be considered as part of the initial management. Additional data are needed to further evaluate this drug in a prospective manner and in a larger population of patients.