Sulfasalazine
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Generalised vitiligo: case report A man in his late 50’s developed generalised vitiligo while being treated with sulfasalazine for dermatitis herpetiformis and celiac disease. The man visited dermatological clinic with 30 years history of dermatitis herpetiformis and celiac disease for a biannual skin examination at the age of 59 years. He had initially received, colchicine 0.6mg twice daily for a few weeks, but had no benefit. He was additionally treated with dapsone 50mg. Subsequently, he had developed peripheral neuropathy and dapsone was discontinued. He had been started on treatment with sulfasalazine 1000 to 1500mg twice daily [route not stated]. He had a significant improvement in dermatitis herpetiformis in the previous year, following treatment with sulfasalazine. Whole body skin examination showed, symmetrically distributed patches and asymptomatic white macules over the neck, face, trunk, shoulders, buttocks, lower and upper extremities. The man reported, spreading and development of the white patches in the last 3 months. Wood’s lamp test revealed bluish fluorescence and sharpness of borders of depigmented areas. Histological examination of the right upper arm revealed, pigmentation of basal keratinocyte and a complete loss of basal melanocyte consistent with generalized vitiligo. The histopathologic diagnosis was supported by multiplex immunostaining, SOX-10/MART-1 and the FontanaMasson stain. He had developed generalized vitiligo after 11 months of treatment with sulfasalazine. Author comment: "The novelty of this case is in the fact that biochemical pathways, triggered by sulfasalazine, exist and may result in the development of vitiligo." Turkowski Y, et al. Sulfasalazine-induced generalized vitiligo in a patient with dermatitis herpetiformis and celiac disease. Dermatologic Therapy 32: No. 5, SepOct 2019. Available from: URL: http://doi.org/10.1111/dth.13007 803434936 USA
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Reactions 23 Nov 2019 No. 1780
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