Does anybody know an effective therapy for erythema elevatum et diutinum after failure of corticosteroids, dapsone, methotrexate and adalimumab?
If his immune status is known then it may become a marker of HIV, sometimes
emedicine.medscape.com/article/1083116-overview, has a mention of sulfapyridine, niacinamide and intermittent plasma exchange for control of IgA Paraprotenemia.
I hope something will help this patient.. eagerly awaiting to know.
Pathology of it is considered as similar to Arthus reaction. It is surprised that glucocorticoids and dapsone are not effective. For immune complex disease you can try heparin (or derivatives) and large doses of vitamin B6.
Dapsone (diaminodiphenylsulfone) is the treatment of choice for erythema elevatum diutinum (EED) have shown a good response. The dosage depends on each patient and have a suppressive effect as shown by the recurrence of erythema elevatum diutinum after drug withdrawal. Sulfapyridine has had similar effects as dapsone. niacinamide was found to be helpful in some cases, as wellas Intermittent plasma exchange (PLEX) was shown to control IgA paraproteinemia associated with EED. The IgA levels responded to PLEX treatment, followed by consolidative doses of cyclophosphamide. This treatment might be promising for the control of severe erythema elevatum diutinum that is not controlled by dapsone. Systemic steroids generally have not been found to be effective.
Dear Dr. Bashir,
thanks a lot for your commments. In this case dapsone was without any effect. Corticosteroids either. Sulfapyridine has not been used since dapsone was not effective. PLEX is not available but the patient doesn't have a paraproteinemia at all.
The same is true for cyclosporin A.
- Badges
- Science method
- Similar topics
- Methodology