Dapsone in the Management of Acne Vulgaris

Abstract

Dapsone has had a long history of use in medicine dating back to the 1930s although the compound was originally discovered in 1908. The drug has been successfully deployed in the treatment of a range of conditions including leprosy, malaria, dermatitis herpetiformis, tuberculosis, and opportunistic infections such as pneumocystis pneumonia in patients with human immunodeficiency virus. Dapsone possesses both antibacterial and anti-inflammatory properties, and this dual action was utilized in the management of moderate to severe acne. However, the adverse effect profile of the drug limited its usefulness as an anti-acne therapy, and Dapsone use was superseded by isotretinoin during the 1980s. Dapsone was resurrected as an acne therapy in 2008 after the introduction of Aczone, a topical formulation of the drug with fewer side effects and was deemed suitable for patients with mild-to-moderate disease. Aczone is currently only available in the United States and Canada. Although clinical studies suggest that the drug is effective, the lack of comparative studies with established therapies makes the position of Aczone in the management of acne more difficult to define.