Alternative to preds in sterile nodular panniculitis?

RE: Alternative to preds in sterile nodular panniculitis?

Francisco Gomez — Tue, 15 Mar 2016 14:33:46 GMT

Thank you for your input guys.

I'm not a huge fan of cyclosporin, but I will try and reduce prednisolone a bit slower. Did not know about niacinamide +/- doxycycline, will give it ago if I don't manage to sort the problem.

Thanks again!

RE: Alternative to preds in sterile nodular panniculitis?

Andrew Kent — Tue, 15 Mar 2016 13:05:55 GMT

Hi Francisco,

I'm no dermatologist but believe you can use niacinamide +/- doxycycline in these cases like some other immune-mediated skin diseases and that may allow you to stop other immunosuppressants in the future.

But in terms of steroids - I would suspect you will be looking at using them long term and yes the taper should be quite slow (every few weeks rather than every few days). As Rob says, ciclosporin would be the main alternative.

Andy

RE: Alternative to preds in sterile nodular panniculitis?

Emily Rainbow — Tue, 15 Mar 2016 12:44:39 GMT

I sometimes switch to methylprednisolone if side effects on plain prednisone too much. No experience with this condition though.

RE: Alternative to preds in sterile nodular panniculitis?

Rob Loxley — Mon, 14 Mar 2016 19:49:22 GMT

Ciclosporin is an option

RE: Alternative to preds in sterile nodular panniculitis?

John Flynn — Mon, 14 Mar 2016 13:53:25 GMT

No expert myself (and interested to hear what the experts have to say), but if short-term side effects currently being experienced are not problem, then I'd stick to 0.5mg/kg (2mg pred) q24hrs if working and reduce again after a month to 1.5mg pred q24hrs, then another month 1mg pred q24hrs, then another month 0.5mg pred q24hrs, then another month 0.5mg pred q48hrs, then another month 0.5mg pred twice weekly and then stop. If relapse occurred at any stage, I'd go back to the previous dose that was effective (assuming I wasn't questioning my diagnosis) and halve the speed/amount by which reductions were made. If had to stay on a lowish-dose of pred full-time I wouldn't worry about it unless side effects were evident and problematic.