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The Effect of Clofazimine Therapy

Lourdes Baranda, MD; Bertha Torres-Alvarez, MD; Roberto Cortes-Franco, MD; Benjamin Moncada, MD; Diana P. Portales-Perez, MsC; Roberto Gonzalez-Amaro, MD

Arch Dermatol. 1997;133(3):325-329.

Abstract
Objectives
To assess the expression of several cell adhesion and lymphocyte activation molecules in erythema dyschromicum perstans lesions, and to evaluate the effect of clofazimine therapy on the expression of these molecules.

Design and Methods
A prospective study. Skin biopsy samples were obtained from patients before and after 3 months of clofazimine therapy, and the expression of cell adhesion and activation molecules was assessed by an immunohistochemical technique.

Setting
This study was performed in a clinical referral center and an immunology research laboratory.

Patients
We studied 6 patients with erythema dyschromicum perstans. A diagnosis was made on the basis of clinical and histological criteria. Two patients discontinued participation in the study: one because of adverse effects and the other for unknown reasons.

Interventions
Patients were treated with clofazimine, 100 mg/d, for 3 months.

Main Outcome Measures
Expression of cell adhesion and lymphocyte activation molecules in skin biopsy specimens before and after clofazimine therapy.

Results
Before clofazimine therapy, we detected a noticeable expression of intercellular adhesion molecule 1 and major histocompatibility complex class II molecules (HLA-DR) in the keratinocyte basal cell layer. In addition, CD36, a thrombospondin receptor that is not expressed by normal skin, was detected in the strata spinosum and granulosum. The dermal cell infiltrate expressed the activation molecule AIM/CD69 and the cytotoxic cell marker CD94. After clofazimine therapy, the expression of intercellular adhesion molecule 1 and HLA-DR disappeared, as well as the mononuclear cell infiltrate.

Conclusions
Our results suggest that some cell adhesion and activation molecules are involved in the pathogenesis of erythema dyschromicum perstans. Clofazimine appears to have an important effect on the inflammatory phenomenon of erythema dyschromicum perstans.

Arch Dermatol. 1997;133:325-329

Author Affiliations
From the Department of Immunology, School of Medicine, University of San Luis Potosí, San Luis Potosí (Drs Baranda, Torres-Alvarez, Moncada, and Gonzalez-Amaro and Ms Portales-Perez), and the Department of Dermatology, Hospital General Manuel Gea Gonzalez, Mexico City, (Dr Cortes-Franco), Mexico.

Footnotes
Accepted for publication August 12, 1996.

This work was supported by grant C93-FAI-11-4.87 (Dr Baranda) from the University of San Luis Potosí.

Presented at the 54th Annual Meeting of the American Academy of Dermatology, Washington, DC, February 13, 1996.

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