Hafif-Orta Şiddetli Akne Vulgaris Tedavisinde Topikal Dapson ve Benzoil Peroksitin Etkinlik ve Tolere Edilebilirliği: Retrospektif Bir Çalışma

Year 2024, Issue: Early Access

Sabir Hasanbeyzade , Engin Şenel

https://doi.org/10.18678/dtfd.1503125

Abstract

Amaç: Akne vulgaris, pilosebase ünitenin bir hastalığıdır ve kronik inflamatuar bir süreçtir. Bu çalışmanın amacı hafif ve orta şiddetli akne hastalarında, topikal %5’lik dapson ile topikal %10’luk benzoil peroksiti etkinlik, yan etki ve hasta memnuniyeti açısından karşılaştırmaktır.
Gereç ve Yöntemler: Dermatoloji polikliniğine 20 Haziran 2022 ile 20 Eylül 2022 tarihleri arasında akne şikayeti ile başvuran ve hafif ve orta şiddette akne vulgaris tanısı almış olan hastalar geriye dönük olarak değerlendirildi. Bu çalışmaya, dapson grubunda 48 ve benzoil peroksit grubunda 53 hasta dahil edildi.
Bulgular: Tedavi sonunda, ISGA değerleri ve ISGA'daki iyileşme yüzdesi açısından iki grup arasında istatistiksel olarak anlamlı bir farklılık bulundu, dapson grubunda iyileşme daha fazlaydı (her ikisi için de p=0,001). Kapalı komedon, papül ve püstül, inflamatuvar lezyon ve toplam lezyonların lezyon sayılarındaki azalma yüzdeleri açısından iki grup arasında istatistiksel olarak anlamlı bir farklılık bulundu (dapson grubunda azalma daha fazlaydı, kapalı komedonlar için p=0,038, toplam lezyonlar için p=0,006 ve diğerleri için p<0,001). Dapson kullanan grupta memnun olmayan hasta yoktu (p<0,001). Yan etkiler arasında eritem tüm tedavi süresi boyunca daha sık görüldü, kuruluk ve yanma-batma hissi benzoil peroksit grubunda birinci ayın sonunda daha fazlaydı.
Sonuç: Topikal %5’lik dapson, hafif ve orta şiddetli akne tedavisinde etkilidir ve topikal %10 benzoil peroksit ile karşılaştırıldığında yan etki açısından güvenlidir.

Keywords

akne vulgaris, benzoil peroksit, dapson

Efficacy and Tolerability of Topical Dapsone vs Benzoyl Peroxide in Mild to Moderate Acne Vulgaris Treatment: A Retrospective Study

Abstract

Aim: Acne vulgaris is a disease of the pilosebaceous unit and a chronic inflammatory process. This study aimed to compare topical 5% dapsone and 10% benzoyl peroxide in terms of efficacy, side effects, and patient satisfaction in mild to moderate acne.
Material and Methods: The patients who applied to the dermatology outpatient clinic with the complaint of acne between June 20, 2022, and September 20, 2022, and were diagnosed with mild and moderate acne vulgaris, were retrospectively evaluated. Forty-eight patients in the dapsone group and 53 in the benzoyl peroxide group were included in this study.
Results: At the end of the treatment, a statistically significant difference was found between the two groups in terms of ISGA values and improvement percentage in ISGA, improvement was higher in the dapsone group (both p=0.001). A statistically significant difference was found between the groups in terms of the percentage decrease in lesion counts of closed comedones, papules and pustules, inflammatory and total lesions (decreasement was higher in the dapsone group, p=0.038 for closed comedones, p=0.006 for total lesions and p<0.001 for others). There was no dissatisfied patient in the group using dapsone (p<0.001). Among the side effects, erythema was more common during the whole treatment, and dryness and burning-stinging sensation were higher at the end of the first month in the benzoyl peroxide group.
Conclusion: Topical 5% dapsone is effective in the treatment of mild to moderate acne and is safe in terms of side effects compared to topical 10% benzoyl peroxide.

Keywords

acne vulgaris, benzoyl peroxide, dapsone

References

• Hsu P, Litman GI, Brodell RT. Overview of the treatment of acne vulgaris with topical retinoids. Postgrad Med. 2011;123(3):153-61.
• Kraft J, Freiman A. Management of acne. CMAJ. 2011;183(7):E430-5.
• Sago J, Hall RP. Dapsone. Dermatol Ther. 2002;15(4):340-51.
• Wozel G, Blasum C. Dapsone in dermatology and beyond. Arch Dermatol Res. 2014;306(2):103-24.
• Paniker U, Levine N. Dapsone and sulfapyridine. Dermatol Clin. 2001;19(1):79-86.
• Schmitdt E, Reimer S, Kruse N, Bröcker EB, Zillikens D. The IL-8 release from human keratinocytes, mediated by anti-bodies to bullous pemphigoid autoantigen 180, is inhibited by dapsone. Clin Exp Immunol. 2001;124(1):157-62.
• Booth SA, Moddy CE, Dahl MV, Herron MJ, Nelson RD. Dapsone suppresses intergrin-mediated neutrophil adherence function. J Invest Dermatol. 1992;98(2):130-40.
• Kazmierowski JA, Ross JE, Peizner DS, Wuepper KD. Dermatitis herpetiformis: effects of sulfones and sulfonamides on neutrophil myeloperoxidase-mediated iodination and cytotoxicity. J Clin Immunol. 1984;4(1):55-64.
• Wozel G, Lehmann B. Dapsone inhibits the generation of 5-lipoxygenase products in human polymorphonuclear. Skin Pharmacol. 1995;8(4):196-202.
• Ross CM. The treatment of acne vulgaris with dapsone. Br J Dermatol. 1961;73(10):367-70.
• Jaffuel D, Lebel B, Hillaire-Buys D, Pene J, Godard P, Michel FB, et al. Eosinophilic pneumonia induced by dapsone. BMJ. 1998;317(7152):181.
• Stöckel S, Meurer M, Wozel G. Dapsone-induced photodermatitis in a patient with linear IgA dermatosis. Eur J Dermatol. 2001;11(1):50-3.
• Faghihi G, Rakhshanpour M, Abtahi-Naeini B, Nilforoushzadeh MA. The efficacy of 5% dapsone gel plus oral isotretinoin versus oral isotretinoin alone in acne vulgaris: A randomized double-blind study. Adv Biomed Res. 2014;3:177.
• Del Rosso JQ, Kircik L, Tanghetti E. Management of truncal acne vulgaris with topical dapsone 7.5% gel. J Clin Aesthet Dermatol. 2018;11(8):45-50.
• Tanghetti E, Harper JC, Oefelein MG. The efficacy and tolerability of dapsone 5% gel in female vs male patients with facial acne vulgaris: gender as a clinically relevant outcome variable. J Drugs Dermatol. 2012;11(12):1417-21.
• Draelos ZD, Carter E, Maloney JM, Elewski B, Poulin Y, Lynde C, et al. Two randomized studies demonstrate the efficacy and safety of dapsone gel, 5% for the treatment of acne vulgaris. J Am Acad Dermatol. 2007;56(3):439.e1-10.
• Darjani A, Aboutaleb E, Alizadeh N, Rafiei R, Nejad KG, Nabatchii S, et al. Efficacy, safety, and tolerability of dapsone 5% gel and benzoyl peroxide 5% gel in combination with oral doxycycline in treating moderate acne vulgaris: a randomized clinical trial. Iran J Dermatol. 2022;25(2):132-41.
• Jawade SA, Singh A. Efficacy of dapsone 5% gel in treatment of acne vulgaris. Int J Res Dermatol. 2016;2(4):77-81.
• Kamoji SG, Huggi G, Pise GA, Nayak JJ, Dastikop SV, Patil MN. A double blind randomized study to compare efficacy of 5% dapsone gel vs combination of adapalene-clindamycin gel in the treatment of mild to moderate acne vulgaris. J Dermat Cosmetol. 2018;2(4):202-5.