Colchicine as a novel therapeutic agent in chronic bullous dermatosis of childhood

Background The treatment of chronic bullous dermatosis of childhood (CBDC) so far has been limited to the use of corticosteroids and the sulfa group of drugs, e.g. daspsone and sulfapyridine. Furthermore, the therapy of CBDC cases with associated G6 PD deficiency is restricted only to systemic steroids, Histopathologically CBDC is characterized by the presence of predominantly neutrophilic infiltration and because it has been proven to exert strong anti-inflammatory effects through the inhibition of neutrophils, colchicine was mandated for its use in CBDC. Methods To avoid the detrimental side-effects of the long-term use of steroids in children, an alternative anti-inflammatory drug like colchicine was considered. Patients with G6 PD deficiency and those who were not satisfactorily controlled with steroid therapy, and who in addition developed unacceptable side-effects like cushingoid faces and hypertrichiosis, were treated with the drug. Results Eight patients were given colchicine, five (62.5%) of which showed complete remission within 4-6 weeks of starting the therapy. The remaining three (37.5%) also responded but required adjuvant small doses of steroids to maintain the remissions, The drug was very well tolerated and no side-effects were observed. Conclusions Colchicine is, therefore, found to be an effective treatment in CBDC and has enhanced our armamentarium of therapeutics for this condition, especially in children with G6 PD deficiency.