Emerging treatments

Tetracycline plus niacinamide

A handful of case reports support the use of tetracycline plus niacinamide to treat patients with dermatitis herpetiformis in whom dapsone is not tolerated/ineffective.[2][59][60][61] When used in combination, these drugs are thought to act by suppressing antibody formation and modulation of proinflammatory cytokines, and inhibition of inflammatory cell accumulation and T‑cell activation.[61] This combination of drugs is contraindicated in children. Further research is required before this drug combination can be routinely recommended.

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