Dapsone therapy for the acute inflammatory phase of ocular pemphigoid

Oral dapsone was used to treat five patients who presented in the acute inflammatory phase of ocular pemphigoid. The diagnosis was made clinically by identifying cicatricial changes which were in some cases difficult to find. In all cases it was the inflammatory rather than the cicatricial features which responded to treatment. An initial dose of 100 mg/day was effective without toxicity. When 150 mg/day was used patients experienced side effects. A clinical response was obtained after 1-4 weeks and could be maintained on a dose of between 50 mg on alternate days and 100 mg/day. Therapy was withdrawn during remissions which lasted up to 32 weeks but all cases required continuing therapy which has remained effective. Immunopathological examination was carried out on two occasions in all cases and although positive on at least one occasion the results did not correlate with disease activity or treatment. The inflammatory phase of ocular pemphigoid should be added to the list of diseases responsive to dapsone.