What are the most common uses for Dapsone (Diaminodiphenyl Sulfone)?

From the Guidelines

Dapsone is most commonly used to treat leprosy, dermatitis herpetiformis, and as a second-line treatment for Pneumocystis jirovecii pneumonia (PCP) in patients who cannot tolerate trimethoprim-sulfamethoxazole, with a typical dose of 50-100 mg daily for dermatological conditions and 100 mg daily for PCP prophylaxis. The use of dapsone in treating various conditions is supported by several studies, including a 2016 review article on acute severe ulcerative colitis, which recommends dapsone 100 mg daily as an option for patients with sulfur allergy who require Pneumocystis jiroveci pneumonia (PJP) prophylaxis 1. Additionally, a 2019 guideline on the management of hidradenitis suppurativa suggests dapsone as a third-line treatment option, with a recommended starting dose of 50 mg daily and titration up to 200 mg daily 1. Dapsone works through anti-inflammatory and antimicrobial mechanisms, inhibiting bacterial folate synthesis and neutrophil myeloperoxidase activity. Patients should be monitored for potential side effects, including hemolytic anemia and methemoglobinemia, particularly in those with G6PD deficiency, which should be tested for before starting therapy. Regular blood count monitoring is necessary during treatment.

Some of the key uses of dapsone include:

• Treatment of leprosy (Hansen's disease)
• Treatment of dermatitis herpetiformis, a blistering skin condition associated with celiac disease
• Second-line treatment for Pneumocystis jirovecii pneumonia (PCP) in patients who cannot tolerate trimethoprim-sulfamethoxazole
• Treatment of other autoimmune and inflammatory skin disorders, including linear IgA bullous dermatosis, bullous pemphigoid, and certain types of vasculitis
• Prophylaxis against PCP in immunocompromised patients, often prescribed at 100 mg daily

It's worth noting that dapsone has been used in various other conditions, including acne vulgaris, where a 5% gel formulation is available for topical use 1. However, the most common and established uses of dapsone are in the treatment of leprosy, dermatitis herpetiformis, and as a second-line treatment for PCP. As with any medication, patients should be closely monitored for potential side effects and interactions, and regular blood count monitoring is necessary during treatment.

From the FDA Drug Label

DESCRIPTION Dapsone-USP, 4’-sulfonyl dianiline, is a primary treatment for Dermatitis herpetiformis. It is an antibacterial drug for susceptible cases of leprosy. The most common uses for Dapsone are:

• Dermatitis herpetiformis: as a primary treatment
• Leprosy: as an antibacterial drug for susceptible cases 2

From the Research

Common Uses of Dapsone

The most common uses of Dapsone include:

• Treatment of leprosy, as seen in studies 3, 4, 5, 6
• Treatment of dermatitis herpetiformis, as seen in studies 5, 6, 7
• Treatment of acne vulgaris, as seen in study 5
• Off-label uses in various dermatologic conditions, as seen in studies 5, 6

Dermatological Uses

Dapsone is used in dermatology for its:

• Antimicrobial effects, as seen in study 5
• Anti-inflammatory properties, as seen in study 5
• Treatment of inflammatory and infectious skin conditions, as seen in study 5

FDA-Approved Indications

The US Food and Drug Administration (FDA)-approved indications for Dapsone are:

• Leprosy, as seen in studies 3, 4, 5, 6
• Dermatitis herpetiformis, as seen in studies 5, 6, 7
• Acne vulgaris, as seen in study 5