Treatment of ocular cicatricial pemphigoid with sulfasalazine.

PURPOSE

To assess the outcome of patients with ocular cicatricial pemphigoid (OCP) treated with sulfasalazine as an alternative to dapsone.

DESIGN

Retrospective noncomparative case series.

PARTICIPANTS

Nine patients with biopsy-proven OCP and previous dapsone-related adverse effects (hemolysis and gastrointestinal disturbances) treated with oral sulfasalazine.

METHODS

Clinical data were abstracted from patients' medical records.

MAIN OUTCOME MEASURES

Patients' symptoms, ocular inflammation, conjunctival scarring, complete blood cell count (including reticulocyte count).

RESULTS

At the initiation of sulfasalazine therapy, ocular inflammation was controlled in all patients but one. Mean follow-up was 12 months (range, 2-35 months). Median oral sulfasalazine dosage was 3 g (range, 1-4 g). The disease remained controlled with sulfasalazine alone in four patients (45%). Two patients (22%) required adjunctive oral cyclophosphamide. Adverse effects necessitating drug withdrawal occurred in three patients (33%): hemolysis in two and gastrointestinal disturbances in one.

CONCLUSIONS

Sulfasalazine may be useful in OCP patients with previous dapsone-related adverse effects.