Successful treatment of complex aphthosis with colchicine and dapsone

Objective: To investigate the effectiveness of colchicine and dapsone, 2 corticosteroid-sparing antiinflammatory agents, in the treatment of patients with complex aphthosis (recurrent oral and genital aphthous ulcers or severe, almost constant, multiple oral aphthae in the absence of Behcet syndrome). Design: Retrospective review of medical records. Setting: Tertiary care medical clinic. Patients: Fifty-five patients with complex aphthosis evaluated and treated at Mayo Clinic between January 1, 1998, and July 31, 2007. All the patients were treated according to a therapeutic ladder, starting with colchicine and adding dapsone to treatment of patients who did not have a substantial response (>75% improve-merit) to colchicine or who discontinued colchicine use because of adverse effects. Main Outcome Measures: A substantial response to therapy with colchicine alone, dapsone alone, or colchicine and dapsone combined. Results: Most patients (44 [80%1) had a substantial response to therapy and had no serious adverse effects. Conclusions: Colchicine and dapsone are effective, safe therapies for the treatment of complex aphthosis. Colchicine and dapsone, 2 established drugs also used for gout and leprosy, respectively, and for other dermato- logic disorders, should be considered efficacious in the treatment of complex aphthosis.