Dapsone

Despite its well-known potential for serious toxicity, dapsone has remained the mainstay for therapy for at least dermatitis herpetiformis and leprosy. Dapsone is reported to be effective in numerous other dermatologic diseases and has provided a valuable alternative therapy when other medications are ineffective, poorly tolerated, or deemed too toxic. The therapeutic value of dapsone would be greatly enhanced if countermeasures to its hemolytic toxicity could be found. Studies have shown some improvement in the hemolytic profile with concurrent administration of antioxidants, such as vitamin E, or cytochrome P450 inhibitors, such as cimetidine, but further study is needed. The new millennium will hopefully include advances toward a less hematotoxic agent and extensive controlled clinical trials to document clinical efficacy in the myriad of dermatologic diseases for which dapsone is prescribed.