mycophenolic-acid and Facial-Dermatoses

Topics: Facial Dermatoses; Female; Fluorescent Antibody Technique, Direct; Humans; Immunosuppressive Agents; Middle Aged; Mycophenolic Acid; Pemphigus; Prednisone

Linear scleroderma is a characteristic form of scleroderma that typically affects children. Ocular manifestations may be present, especially when the frontoparietal area of the head is affected. We present the case of a 5-year-old boy with craniofacial linear scleroderma ("en coup de sabre") who developed exudative retinal detachment. Angiographic and neuroimaging findings are presented, and the importance of regular fundus examination is highlighted.

Topics: Child, Preschool; Drug Therapy, Combination; Enzyme Inhibitors; Exudates and Transudates; Facial Dermatoses; Fluorescein Angiography; Glucocorticoids; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Male; Methotrexate; Methylprednisolone; Mycophenolic Acid; Retinal Detachment; Retinal Telangiectasis; Scalp Dermatoses; Scleroderma, Localized

The Risk Evaluation and Mitigation Strategy program that the U.S. Food and Drug Administration has mandated has intensified the counseling associated with prescribing mycophenolate mofetil (MMF), because of its teratogenicity. In this brief report, two children are described who were prescribed MMF and within weeks developed psychiatric symptoms, with rapid resolution after discontinuation of the medication and no recurrence over 4 years of follow-up. Mood disorders are a rare but possible side effect that should be mentioned when discussing MMF with patients and families. Prompt discontinuation of the drug should lead to reversal of symptoms when the drug is implicated.

Topics: Administration, Oral; Adolescent; Dermatitis, Atopic; Dose-Response Relationship, Drug; Drug Administration Schedule; Facial Dermatoses; Female; Follow-Up Studies; Humans; Male; Mood Disorders; Mycophenolic Acid; Recurrence; Risk Assessment; Sampling Studies; Scleroderma, Localized; Severity of Illness Index; United States; United States Food and Drug Administration; Withholding Treatment

Chronic actinic dermatitis (CAD) is a persistent photodermatosis that usually affects elderly men. We report two male patients, aged 55 years (patient A) and 49 years (patient B), who presented with an eczematous eruption on sun-exposed skin. Phototesting revealed a markedly reduced 24-h minimal erythema dose (MED). Both patients had refractory disease and developed significant side-effects to conventional therapies, including topical steroids, prednisolone, psoralen with ultraviolet A, azathioprine and ciclosporin. They had each received at least 6 years of treatment prior to commencing mycophenolate mofetil (MMF). Each noted a significant improvement in symptoms within 6 weeks and subsequent clearing of the eczematous lesions. Patient A still requires continuous treatment with MMF 500 mg twice daily to prevent relapses. Patient B maintains remission by using MMF 1 g twice daily only during the spring and summer months. Both patients have tolerated the treatment well with no abnormalities in blood cell counts or liver biochemistry. Since commencing MMF, their quality of life has significantly improved. These observations suggests that MMF should be considered as an alternative treatment to conventional therapies for refractory CAD.

Topics: Chronic Disease; Dermatologic Agents; Facial Dermatoses; Humans; Immunosuppressive Agents; Male; Middle Aged; Mycophenolic Acid; Photosensitivity Disorders; Secondary Prevention; Treatment Outcome

Pemphigus foliaceus is an autoimmune blistering disease of unknown origin with antibodies produced against desmoglein 1, an adhesive protein found in the desmosomal cell junction in the suprabasal layers of the epidermis. The disease is primarily treated with corticosteroids and corticosteroid-sparing immunosuppressive agents. We report a case of pemphigus foliaceus successfully treated with mycophenolate mofetil. It remains to be seen whether this agent has a significant effect on the course of the disease and remission induction.

Topics: Adult; Enzyme Inhibitors; Facial Dermatoses; Female; Humans; Immunosuppressive Agents; IMP Dehydrogenase; Mycophenolic Acid; Pemphigus; Prodrugs