Dapsone in the treatment of cutaneous lupus erythematosus

Thirty-three patients with chronic discoid lupus erythematosus (DLE) who had received dapsone for 1-27 months were reviewed. The dapsone treatment gave excellent results in 8 patients (24%), some effect in 8 patients (24%), while no response was seen in 17 patients (52%). Of the patients who had earlier been treated with hydroxychloroquine (HCQ), 76% responded excellently to the treatment. Of 6 patients who received a combined dapsone and HCQ therapy, 2 responded well. Six patients (18%) terminated the dapsone treatment because of side effects, none of which were serious. It is concluded that dapsone might be an alternative or a supplement to HCQ in the treatment of DLE, when the latter causes adverse reactions or fails to be effective. However, we find that HCQ remains the drug of choice when systemic treatment is needed.