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Minimal Erythema Dose (MED) Testing
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Published on: May 28, 2013

Allopurinol in dermatology.

Tsen-Fang Tsai1, Ting-Yu Yeh

  • 1Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan. tftsai@yahoo.com

American Journal of Clinical Dermatology
|June 1, 2010
PubMed
Summary

Allopurinol, a gout medication, shows promise for rare skin diseases by reducing inflammation and improving vascular function. Genetic markers can now predict severe reactions like Stevens-Johnson syndrome.

Area of Science:

  • Dermatology
  • Pharmacology
  • Genetics

Background:

  • Off-label drug use is prevalent in dermatology, particularly for rare conditions like perforating dermatosis.
  • Allopurinol, primarily for hyperuricemia, is gaining attention for other uses, including dermatologic conditions.
  • Allopurinol is associated with severe cutaneous adverse reactions, with recent genomic studies identifying HLA markers for susceptibility to Stevens-Johnson syndrome and toxic epidermal necrolysis.

Purpose of the Study:

  • To explore the potential therapeutic applications of allopurinol in various dermatologic disorders.
  • To highlight the mechanisms underlying allopurinol's efficacy in skin conditions.
  • To discuss the significance of genetic predispositions for adverse reactions.

Main Methods:

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  • Review of existing literature on allopurinol's use in dermatology.
  • Analysis of genomic studies identifying HLA markers for adverse reactions.
  • Clinical observations of allopurinol's effects in acquired reactive perforating collagenosis, sarcoidosis, psoriasis, and granulomas.

    • Main Results:

    • Allopurinol has demonstrated efficacy in treating acquired reactive perforating collagenosis, sarcoidosis, psoriasis, and granulomas.
    • Genomic studies have identified specific HLA markers associated with increased risk of severe cutaneous adverse reactions to allopurinol.
    • Potential therapeutic mechanisms include antioxidation, anti-inflammatory properties, and improvement of vascular function.

    Conclusions:

    • Allopurinol presents a viable therapeutic option for specific dermatologic conditions, including rare perforating dermatoses.
    • Understanding genetic susceptibility is crucial for safe allopurinol prescription in dermatology.
    • Further research into allopurinol's mechanisms may reveal broader applications in managing inflammatory and vascular skin diseases.