Treatment of cicatricial (benign mucous membrane) pemphigoid with dapsone

Treatment of cicatricial pemphigoid is a problem because patients afflicted are elderly, the disease is chronic, systemic agents required for control are potentially toxic (particularly to older patients), and the disease is often in an advanced stage when the diagnosis is established and requires aggressive therapy for control. We selected dapsone as an alternative anti-inflammatory agent because it has provided control in a subset of patients with bullous pemphigoid, five of six who had oral lesions. Twenty-four patients with cicatricial pemphigoid were treated with dapsone. Twenty (83.3%) had partial or complete control with mild to no inflammatory activity. Control was obtained within 4 weeks in eleven of the twenty patients. The use of dapsone was discontinued in two patients because it failed to control their disease and in four patients (two with control) because of drug-related side effects. Cicatricial pemphigoid may be added to the list of dapsone-responsive dermatoses.