Chronic spontaneous urticaria is marked by recurrent bouts of hives. First line treatment is typically second-generation H1-antihistamines at up to four times the typical dose. But this therapy is unsuccessful in up to 50% of patients. Many other treatments have been tried for chronic spontaneous urticaria. Recently, a medical records review evaluated the use of dapsone in the treatment of chronic spontaneous urticaria. Dapsone is a sulfone antibiotic with both antimicrobial and inflammatory properties.

Among the 79 patients, improvement in chronic urticaria was noted in 62 patients treated with dapsone, with a complete response in 24 patients. Eighteen adverse events were reported, sixteen mild and two serious. Dapsone is well known to cause a decrease in hemoglobin levels, but this is considered a mild side-effect that can generally be managed.

In summary, dapsone can be considered for treatment of chronic urticaria in patients who have failed H1-antihistamine therapy. It has been shown to be an effective and well-tolerated therapy. Results may be seen as early as one month into treatment, but complete response typically took around five months.

Liang SE, Hoffmann R, Peterson E, Soter NA. Use of Dapsone in the Treatment of Chronic Idiopathic and Autoimmune Urticaria. JAMA Dermatol. 2019;155(1):90–95. doi:10.1001/jamadermatol.2018.3715


Back to all Posts