Skin pigmentation & icthyosis like side effects are seen in:
B i.e. Clofazimine Dapsone Dose and side Effects Dose is 1-2mg/kgQ and half life is >24 hoursQ. Clinical response is seen at doses ranging from 25-200mg/day (but rarely requiring 300mg/d.) Doses of 100mg in healthy persons and 50mg in healthy individuals with a G6PD deficiency do not cause hemolysis. Sulfones tend to be retained in skin, muscle and especially in lever and kidney for upto 3 weeks. Intestinal reabsorption of sulfones excreted in bile contributes to long term retention in blood stream. G6PD protects RBCs against oxidative stress. Dapsone an oxidant causes severe hemolysis (Vt haemolytic anemia most common side effect)Q in patients with G6PD deficiency. Hemolysis and methemaglobinemia develops in almost every individual treated with 200-300mg of dapsone per day. MethemoglobinemiaQ also is common and may be severe in NADH-dependent methemoglobin reductase deficiency. Idiosyncratic or allergic like distal peripheral neuropathy (almost always motor occasionally with a sensory component); which is reversible with dose decrease or discontinuation. Sulfone syndrome (Mono nucleosis like hypersensitivity) usually develops between 2 and 7 weeks after staing drug and inevitably includes the triad of fever, rash (exfoliative or SJ like) and hepatitis. Agranulocytosis, leukopenia severe hypoalbuminea are other S/ Es. Theraputic uses Infections: DDS is effective against M.leprae, MAC, M.kanssii bacteria; plasmodium falciparum and toxoplasma gondii parasites; and pneumocystic jiroveci fungus and so is used in LeprosyQ MalariaQ (combined with chlor proguani) ActinomycosisQ, rhinosporidosis, P. jiroveci infection and prophylaxis, and P. Carinii pheneumonia prophyloxis in sulfa allergic immuno compromised patients, and for T. gondii prophylaxis. Non-infections diseases with consistent response to dapsone include Dermatitis herpetiformis (drug of choice)Q Erythema elevatum diutinum, linear immunoglobuline A dermatosis/ chronic bullous dermatosis of childhood and bullous eruption fo SLE. *Other non-infectious conditions in which DDS has found sporadic (less rapid, regular or predictable) success have a unifying feature of having granulocytes (neutrophils or eosinophils) as the predominant infiltrating cell. Examples are: Collagen vascular disease e.g. RA, rheumatoid papules, relapsing plychondritis, subacute cutaneous lupus erythematosus, chronic cutaneous lupus, lupus profundus; various vasculitides including cutaneous PAN, HS purpura, chronic leukocytoclastic vasculitis without internal organ involvement and Bechet syndrome. Autoimmune diseases e.g. steroid resistant or dependent ITP, bullous pemphigoid, cicatricial (mucous membrane) pemphigoid, paicularly in early inflammatory phase of ocular disease, sobcorneal pustular dermatoses, pemphigus vulgaris/foliaceaous and uicarial vasculitis. - Inflammatory conditons like acne vulgaris and acne conglobate (but is not recommended).
Rifampcin
Clofazimine
Dapsone
Steroid