Erythema Elevatum Diutinum Treatment & Management

Updated: Mar 22, 2019
  • Author: Firas G Hougeir, MD; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

Dapsone (diaminodiphenylsulfone) revolutionized the treatment of patients with erythema elevatum diutinum (EED). Several studies and clinical experience have shown a good response to dapsone, therefore making it the treatment of choice. [24] The dosage depends on each patient. Sulfones have a suppressive effect on erythema elevatum diutinum, as shown by the recurrence of erythema elevatum diutinum after drug withdrawal. Systemic steroids generally have not been found to be effective.

Sulfapyridine has had similar effects as dapsone.

In one study, niacinamide was found to be helpful in suppressing erythema elevatum diutinum. [25]

Intermittent plasma exchange (PLEX) was shown to control IgA paraproteinemia associated with erythema elevatum diutinum. [26] The IgA levels responded to PLEX treatment, followed by consolidative doses of cyclophosphamide. This treatment might be promising for the control of severe erythema elevatum diutinum that is not controlled by dapsone.

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Surgical Care

Surgical excision of the lesions is sometimes performed to provide symptomatic relief if medical therapy is not effective. [27]

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Diet

A strict gluten-free diet was shown to help achieve full healing of a patient with celiac disease for whom dapsone therapy was not completely effective. [28]

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