Pemphigus vegetans is a rare variant of pemphigus vulgaris and is characterized by vegetating lesions in the inguinal folds and mouth and by the presence of autoantibodies against desmoglein 3. Two clinical subtypes of pemphigus vegetans exist, which are initially characterized by flaccid bullae and erosions (the Neumann subtype) or pustules (the Hallopeau subtype). Both subtypes subsequently develop into hyperpigmented vegetative plaques with pustules and hypertrophic granulation tissue at the periphery of the lesions. Oral administration of corticosteroids alone does not always induce disease remission in patients with pemphigus vegetans. We report here on a 63-year-old woman with pemphigs vegetans. She had a 2-year history of vegetating, papillomatous plaques on the inguinal folds and erosions of the oral mucosa. The enzyme-linked immunosorbent assay was positive for anti-desmoglein 3, but it was negative for anti-desmoglein 1. She was initially treated with systemic steroid, but no improvement was observed. The patient was then successfully treated with a combination of systemic steroid and dapsone with a good clinical response.
Administration, Oral ; Adrenal Cortex Hormones ; Autoantibodies ; Blister ; Dapsone ; Desmoglein 3 ; Enzyme-Linked Immunosorbent Assay ; Female ; Granulation Tissue ; Humans ; Middle Aged ; Mouth ; Mouth Mucosa ; Pemphigus

Canine Subcorneal pustular dermatosis (CSPD) represents a sterile, superficial, pustular skin disease of unknown cause but may be a variant of pemphigus foliaceus. A 7-year-old, intact female, mixed dog presented with 3-month history of pruritic multiple pustules and crusts. Direct smears from intact pustules revealed numerous nondegenerate neutrophils, some acantholytic cells, and bacterial culture was negative. Histologic examination of lesional skin showed subcorneal pustules filled with neutrophils and acantholytic cells. The direct immunofluorescence tests stained with IgG, IgA, IgM, C3 were negative. Oral administration of dapsone (1 mg/kg/q8h) was initiated and it was reduced to 1 mg/kg/q12h with good control of the lesions.
Administration, Oral ; Animals ; Dapsone ; Dogs ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Neutrophils ; Pemphigus ; Skin ; Skin Diseases ; Skin Diseases, Vesiculobullous

OBJECTIVETo analyze the trends of case detection and other indicators of leprosy in China during 1985-2002.

METHODSData reported by each province were collected by China National Leprosy Database in Nanjing P.R. China. All data about registered cases were put into computer for analysis.

RESULTSFrom 1985 to 2002, a total of 49,477 new leprosy cases had been detected. Among them, 69.5% were multibacillary cases and 25.4% had grade 2 disability. The child cases aged below 15 years accounted for 3.74% of total cases. Totally, 5824 cases and 303 cases relapsed after dapsone (DDS) mono-therapy and multidrug therapy (MDT), respectively. Case detection showed a marked reduction from 0.47/100,000 in 1985 to 0.18/100,000 in 1993 although there were several spurts due to operational factors. From 1994, case detection showed no significant decline. The grade 2 disability among new patients decreased from 31.4% in 1985 to 23.4% in 2002. The child case detection rate among new cases fluctuated between 2.70%-3.56% from 1999 to 2002. The incidence of relapse declined after the introduction of DDS mono-therapy. However, it increased after the introduction of MDT.

CONCLUSIONChina experiences in leprosy control show that it will take a long time with continuing present leprosy control activities to bring down the case detection and other indicators to a very low level even after reaching the elimination goal of leprosy.

Adolescent ; Adult ; Age Factors ; Child ; China ; epidemiology ; Communicable Disease Control ; trends ; Dapsone ; administration & dosage ; therapeutic use ; Disability Evaluation ; Drug Therapy, Combination ; Humans ; Incidence ; Leprostatic Agents ; administration & dosage ; therapeutic use ; Leprosy ; drug therapy ; epidemiology ; prevention & control ; Recurrence

Anti-Inflammatory Agents ; administration & dosage ; Arthritis ; diagnosis ; drug therapy ; etiology ; physiopathology ; Arthritis, Rheumatoid ; diagnosis ; Clofazimine ; administration & dosage ; Dapsone ; administration & dosage ; Delayed Diagnosis ; Diagnosis, Differential ; Humans ; Leprostatic Agents ; administration & dosage ; Leprosy ; complications ; diagnosis ; drug therapy ; physiopathology ; Male ; Middle Aged ; Prednisolone ; administration & dosage ; Rifampin ; administration & dosage ; Treatment Outcome

Methemoglobin (MetHb) is an oxidation product of hemoglobin in which the sixth coordination position of ferric iron is bound to a water molecule or to a hydroxyl group. The most common cause of acquired MetHb-emia is accidental poisoning which usually is the result of ingestion of water containing nitrates or food containing nitrite, and sometimes the inhalation or ingestion of butyl or amyl nitrite used as an aphrodisiac. We herein report a case of MetHb-emia after ingestion of an aphrodisiac, later identified as dapsone by gas chromatograph/mass selective detector (GC/MSD). A 24-year old male was admitted due to cyanosis after ingestion of a drug purchased as an aphrodisiac. On arterial blood gas analysis, pH was 7.32, PaCO2 26.8 mmHg, PaO2 75.6 mmHg, and bicarbonate 13.9 mmol/L. Initial pulse oxymetry was 89%. With 3 liter of nasal oxygen supplement, oxygen saturation was increased to 90-92%, but cyanosis did not disappear. Despite continuous supplement of oxygen, cyanosis was not improved. On the fifth hospital day, MetHb was 24.9%. Methylene blue was administered (2 mg/kg intravenously) and the patient rapidly improved. We proved the composition of aphrodisiac as dapsone by the method of GC/MSD.
Administration, Oral ; Adult ; Antidotes/therapeutic use ; Aphrodisiacs/adverse effects* ; Case Report ; Cyanosis/drug therapy ; Cyanosis/chemically induced ; Cyanosis/blood ; Dapsone/adverse effects* ; Human ; Male ; Methemoglobinemia/drug therapy ; Methemoglobinemia/chemically induced* ; Methylene Blue/therapeutic use

OBJECTIVETo study the effect of ferment powder caterpillar fungus on cytochrome P450 isozymes CYP1A2, CYP3A4 and CYP2E1.

METHODThe methods of Cocktail probe drugs were used. The rats were randomly divided into two groups. One group were given ferment powder caterpillar fungus once daily orally for ten days. Another group received orally normal saline one daily as the blank control. After ten days of treatment, the rats were given probe drugs of coffine, dapsone and chlorzoxazone and the blood was taken out by femoral catheterization. The plasma concentration of probe drugs were determined by HPLC. Data of plasma drug level-time were disposed with DAS Ver 2.0.

RESULTThe metabolism of caffeine and dapsone speeded up after receiving ferment powder caterpillar fungus, but the metabolism of chlorzoxazone was hardly changed.

CONCLUSIONIt suggested that ferment powder caterpillar fungus tended to be the inducer of CYP1A2 and CYP3A4. But the CYP2E1 was hardly affected.

Animals ; Caffeine ; metabolism ; Chlorzoxazone ; metabolism ; Cytochrome P-450 Enzyme Inhibitors ; Cytochrome P-450 Enzyme System ; metabolism ; Dapsone ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Fermentation ; Male ; Random Allocation ; Rats ; Rats, Wistar

Although 4,4'-diaminodiphenylsulfone (DDS, dapsone) has been used to treat several dermatologic conditions, including Hansen disease, for the past several decades, its mode of action has remained a topic of debate. We recently reported that DDS treatment significantly extends the lifespan of the nematode C. elegans by decreasing the generation of reactive oxygen species. Additionally, in in vitro experiments using non-phagocytic human fibroblasts, we found that DDS effectively counteracted the toxicity of paraquat (PQ). In the present study, we extended our work to test the protective effect of DDS against PQ in vivo using a mouse lung injury model. Oral administration of DDS to mice significantly attenuated the lung tissue damage caused by subsequent administration of PQ. Moreover, DDS reduced the local expression of mRNA transcripts encoding inflammation-related molecules, including endothelin-1 (ET-1), macrophage inflammatory protein-1alpha (MIP-1alpha), and transforming growth factor-beta (TGF-beta). In addition, DDS decreased the PQ-induced expression of NADPH oxidase mRNA and activation of protein kinase Cmicro (PKCmicro). DDS treatment also decreased the PQ-induced generation of superoxide anions in mouse lung fibroblasts. Taken together, these data suggest the novel efficacy of DDS as an effective protective agent against oxidative stress-induced tissue damages.
Animals ; Cells, Cultured ; Chemokine CCL3/drug effects/metabolism ; Dapsone/*administration & dosage ; Endothelin-1/drug effects/metabolism ; Fibroblasts/drug effects ; Herbicides/*antagonists & inhibitors/toxicity ; Lung Injury/chemically induced/*prevention & control ; Male ; Mice ; Mice, Inbred BALB C ; Oxidative Stress ; Paraquat/*antagonists & inhibitors/toxicity ; Protective Agents/*administration & dosage ; Protein Kinase C/genetics/metabolism ; Superoxides/analysis ; Transforming Growth Factor beta/drug effects/metabolism