fumarates and Skin-Diseases

Sarcoidosis is a rare, systemic disease that is characterized by the formation of granulomas in various organs, including the skin. As the etiology remains unknown, the treatment of sarcoidosis is challenging. We present a 47-year-old female patient with progressive, multi-organ sarcoidosis who had a complete clinical improvement of the skin lesions, a moderate reduction in pulmonary opacities on chest X-ray, a marked subjective improvement in general status and pulmonary efficiency and a marked reduction in serum angiotensin-converting enzyme and soluble interleukin-2 receptor after 6 months of therapy with fumaric acid esters. The present case and similar reports in the literature highlight the probable efficacy of fumaric acid esters in the treatment of sarcoidosis and other non-infectious, granulomatous diseases.

Topics: Administration, Oral; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Fumarates; Humans; Middle Aged; Radiography, Thoracic; Rare Diseases; Sarcoidosis; Sarcoidosis, Pulmonary; Severity of Illness Index; Skin Diseases; Treatment Outcome

Hand eczema is a common distressing skin problem. It is an immune reaction to haptens. Thus, substances that inhibit Immune system can be effective in the treatment of hand eczema. In this study, topical fumaric acid 5% cream is compared with topical steroid in the treatment of hand eczema. Patients with hand eczema were randomly divided into two groups. One group received fumaric acid 5% in a cream base, and the other received triamcinolone 0.1% in the same cream base. Both groups used creams twice daily for one month. Patients were checked for erythema, excoriation, population and lichenification, EASI score, and pruritus before and after treatment. In both groups, the mean of all signs of the disease and EASI score decreased after one month of treatment. There was no significant difference between the two treatments in decreasing erythema, but excoriation, population, lichenification, EASI score and itching were all decreased more in triamcinolone 0.1 % group. Although fumaric acid can inhibit the immune system; it was less effective for the treatment of all signs of hand eczema except erythema in comparison to triamcinolone. These results may be justified for two reasons: low penetration of topical fumaric acid through the skin or a low concentration used in this study.

Topics: Administration, Topical; Adult; Dose-Response Relationship, Drug; Double-Blind Method; Eczema; Female; Follow-Up Studies; Fumarates; Glucocorticoids; Hand; Humans; Male; Skin Cream; Skin Diseases; Treatment Outcome; Triamcinolone

Noninfectious granulomatous skin diseases are inflammatory disorders of unknown aetiology which are often recalcitrant to common anti-inflammatory treatment regimens. Recently, in several case reports, fumaric acid esters (FAE) have proved beneficial in granulomatous skin diseases, but studies on a larger collection of consecutive patients have not yet been performed.. To investigate the therapeutic efficacy of FAE for the treatment of granulomatous skin diseases.. The therapeutic efficacy and side-effects of FAE were analysed retrospectively in 32 patients with disseminated granuloma annulare (n = 13), annular elastolytic giant cell granuloma (n = 3), sarcoidosis (n = 11), necrobiosis lipoidica (n = 4), or granulomatous cheilitis (n = 1).. Three patients discontinued treatment within 4 weeks because of side-effects. Of the remaining 29 patients, 18 patients responded to treatment with FAE. Marked improvement or complete clearance was seen in seven patients. We observed a slight to moderate improvement in 11 patients, and 11 patients did not respond. In patients showing a complete remission, the maximum effect was observed after 8.5 months (SD +/-6 months, range 3-20 months). In two patients with systemic sarcoidosis, the pulmonary changes improved in parallel with the skin. Side-effects were usually mild and resolved spontaneously upon dose reduction or discontinuation of the therapy.. The data presented here indicate that FAE may be considered for the treatment of recalcitrant granulomatous skin disease.

Topics: Adolescent; Adult; Aged; Cheilitis; Drug Administration Schedule; Esters; Female; Fumarates; Granuloma Annulare; Granuloma, Giant Cell; Humans; Male; Middle Aged; Necrobiosis Lipoidica; Retrospective Studies; Sarcoidosis; Skin Diseases

The new antihistamine, HC20-511 (Sandoz), was compared with Dimetinden (Fenistil retard) in a single-blind comparative study in 42 patients with dermatoses, 28 of whom suffered from chronic urticaria. HC20-511 had a better effect, especially in chronic urticaria, where pruritus, erythema and papules quickly disappeared. The effect appeared somewhat faster than and lasted as long as that of Dimetinden, although HC20-511 is not a retard-preparation unlike the Dimetinden preparation used for comparison. HC20-511 also caused less side effects.

Topics: Adolescent; Adult; Aged; Chronic Disease; Clinical Trials as Topic; Dimethindene; Drug Therapy, Combination; Female; Fumarates; Histamine H1 Antagonists; Humans; Male; Middle Aged; Piperidines; Pruritus; Skin Diseases; Thiophenes; Urticaria; Vomiting

Topics: Clinical Trials as Topic; Dermatitis, Contact; Drug Eruptions; Exanthema; Female; Fumarates; Histamine H1 Antagonists; Humans; Male; Mycosis Fungoides; Neurodermatitis; Pruritus; Pyrrolidines; Scabies; Skin Diseases; Skin Neoplasms; Urticaria

Fumaric acid esters lead to reduction of cell fusion and inhibition of giant cell formation in vitro, which is considered to be a reason for their therapeutic effect on cutaneous granulomatous diseases. We have reported that successful treatment of the skin lesions of a patient with recalcitrant systemic sarcoidosis with Fumaderm® (Biogen, Munich, Germany; 360-720 mg/day dimethyl fumarate) had to be discontinued due to the development of lymphocytopenia. Therefore, we treated two further patients with the low-dose Fumaderm® Initial (90 mg/day dimethyl fumarate) and observed a partial remission of the skin lesions over a minimum 18 month follow-up without signs of lymphocytopenia.. Fumarsäureester führen zu einer Verringerung der Zellfusion und zur Hemmung der Riesenzellbildung in vitro, die ein Grund für die therapeutische Fumarsäureester-Wirkung auf kutanen Läsionen granulomatöser Erkrankungen sein könnte. Wir berichteten, dass eine erfolgreiche Therapie der Hautveränderungen einer therapieresistenten systemischen Sarkoidose mit Fumaderm® (Biogen, München, Deutschland; 360–720 mg/Tag Dimethylfumarat) aufgrund einer Lymphozytopenie abgebrochen werden musste. Aus diesem Grund behandelten wir 2 weitere Patienten mit dem niedrig dosierten Fumaderm® initial (90 mg/Tag Dimethylfumarat) und beobachteten eine partielle Remission der kutanen Sarkoidose während mindestens 18 Behandlungsmonaten ohne Entwicklung einer Lymphozytopenie.

Topics: Dimethyl Fumarate; Fumarates; Humans; Sarcoidosis; Skin; Skin Diseases

Psoriasis is a complex inflammatory and hyperproliferative skin disease. The pathogenesis and mechanisms involved are not completely understood, which makes treatment a difficult issue. Angiotensin II, the most active peptide of the renin-angiotensin system, seems to be involved in processes related to psoriasis pathogenesis, such as inflammation and cell proliferation. The aim of this study was to investigate the influence of renin inhibition on inflammation parameters and keratinocyte proliferation in a mouse model of chronic skin inflammation induced by croton oil. Aliskiren had anti-inflammatory effects by reducing levels of tumor necrosis factor-α and interleukin -6, and by inhibiting myeloperoxidase activity. Aliskiren also showed antiproliferative activity by reducing epidermal hyperplasia and proliferating cell nuclear antigen levels. Aliskiren treatment did not induce alterations in the cardiovascular system, normal skin thickness, and organ weight. These results suggest that aliskiren could be a valuable tool to be incorporated in the treatment of hyperproliferative and inflammatory skin disorders such as psoriasis.

Topics: Amides; Angiotensin II; Animals; Anti-Inflammatory Agents; Antihypertensive Agents; Cardiovascular System; Disease Models, Animal; Female; Fumarates; Inflammation; Keratinocytes; Mice; Psoriasis; Renin; Renin-Angiotensin System; Skin Diseases

In the biomedical sector the availability of engineered scaffolds and dressings that control and reduce inflammatory states is highly desired, particularly for the management of burn wounds. In this work, we demonstrate for the first time, to the best of our knowledge, that electrospun fibrous dressings of poly(octyl cyanoacrylate) (POCA) combined with polypropylene fumarate (PPF) possess anti-inflammatory activity and promote the fast and effective healing of mild skin burns in an animal model. The fibers produced had an average diameter of (0.8  ±  0.1) µm and they were able to provide a conformal coverage of the injured tissue. The application of the fibrous mats on the burned tissue effectively reduced around 80% of the levels of pro-inflammatory cytokines in the first 48 h in comparison with un-treated animals, and enhanced skin epithelialization. From histological analysis, the skin thickness of the animals treated with POCA : PPF dressings appeared similar to that of one of the naïve animals: (13.7  ±  1.4) µm and (14.3  ±  2.5) µm for naïve and treated animals, respectively. The density of dermal cells was comparable as well: (1100  ±  112) cells mm(-2) and (1358  ±  255) cells mm(-2) for naïve and treated mice, respectively. The results demonstrate the suitability of the electrospun dressings in accelerating and effectively promoting the burn healing process.

Topics: Animals; Anti-Inflammatory Agents; Bandages; Burns; Cyanoacrylates; Disease Models, Animal; Fumarates; Male; Mice; Mice, Inbred C57BL; Nanofibers; Polypropylenes; Skin Diseases; Ultraviolet Rays; Wound Healing

Topics: Dermatologic Agents; Dermatology; Dimethyl Fumarate; Fumarates; Humans; Immunosuppressive Agents; Skin Diseases

A 61-year old female patient with cutaneous sarcoidosis was treated with fumaric acid esters (Fumaderm). After 12 months of therapy, lesions were markedly improved and treatment was discontinued. 18 months later, the cutaneous lesions recurred, angiotensin converting enzyme (ACE) serum levels were increased and a chest X-ray demonstrated pulmonary involvement. Therapy with fumaric acid esters was again started. The skin showed improvement after 2 months and completely cleared within 17 months, within 4 months ACE levels normalized, and within 10 months radiologic changes markedly resolved. This case demonstrates a possible role for fumaric acid esters not only in the treatment of cutaneous but also systemic sarcoidosis.

Topics: Dermatologic Agents; Dimethyl Fumarate; Female; Fumarates; Humans; Immunosuppressive Agents; Middle Aged; Recurrence; Sarcoidosis; Sarcoidosis, Pulmonary; Skin Diseases; Treatment Outcome

Topics: Aged; Biopsy, Needle; Dose-Response Relationship, Drug; Drug Administration Schedule; Elbow; Esters; Female; Follow-Up Studies; Forearm; Fumarates; Granuloma Annulare; Granuloma, Giant Cell; Humans; Immunohistochemistry; Male; Severity of Illness Index; Skin Diseases; Treatment Outcome

Sarcoidosis is a multisystem disease of unknown origin characterized by the formation of noncaseating granulomas, in particular in the lungs, lymph nodes, eyes, and skin. Systemic treatment for cutaneous sarcoidosis can be used for large disfiguring lesions, generalized involvement, or recalcitrant lesions that did not respond to topical therapy.. We report three patients with recalcitrant cutaneous sarcoidosis who were treated with oral fumaric acid esters (FAE). Three female patients presented with cutaneous sarcoidosis that have proved to be refractory to various therapies, including corticosteroids and chloroquine. We treated the patients with FAE in tablet form using two formulations differing in strength (Fumaderm initial, Fumaderm). Dosage of FAE was performed according to the standard therapy regimen for psoriasis patients. After treatment with FAE (4-12 months), a complete clearance of skin lesions was achieved in the three patients. The side effects observed in this trial correspond to the well-known spectrum of adverse effects of FAE (flush, minor gastrointestinal complaints, lymphopenia).. On the basis of our findings FAE therapy seems to be a safe and effective regimen for patients with recalcitrant cutaneous sarcoidosis. Nevertheless further investigations are necessary to confirm our preliminary results.

Topics: Adult; Dimethyl Fumarate; Female; Fumarates; Humans; Sarcoidosis; Skin Diseases

Topics: Dermatologic Agents; Dermatology; Fumarates; Germany; Humans; Practice Guidelines as Topic; Skin Diseases

Topics: Adult; Blister; Edema; Erythema; Fumarates; Humans; Irritants; Male; Nitriles; Pruritus; Skin Diseases; Water

Topics: Asthma; Child; Child, Preschool; Fumarates; Histamine H1 Antagonists; Humans; Hypersensitivity; Rhinitis, Allergic, Seasonal; Skin Diseases