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July 1992

Treatment of Hyperkeratotic Skin Diseases With R 68151, a Topical 5-Lipoxygenase Inhibitor: Four Case Reports

Arch Dermatol. 1992;128(7):993-994. doi:10.1001/archderm.1992.01680170129026

To the Editor.—  The evidence is substantial that 5-lipoxygenase metabolites of arachidonic acid are involved in the pathophysiology of inflammatory and/or hyperproliferative skin diseases.1R 68151 (1-ethyl-3[4-(4-[4-hydroxyphenyl])-1-piperazinyl) phenyl]5-5-dimethyl)-2-thioxo-4-imidazolidinone) is an in vitro inhibitor of 5-lipoxygenase.2 In the first clinical trial, in 88 patients with psoriasis, 2% R 68151 ointment improved their lesions significantly better than did the vehicle, especially for scaling and erythema.3 Since the effect of topical R 68151 was most prominent on scaling, we investigated the effects of topical R 68151 in other hyperkeratotic inflammatory skin diseases. This communication reports the results on dermatoses, resistant to conventional treatment, in otherwise healthy persons.

Report of Cases.—Case 1.—  A 19-year old man with lamellar ichtyosis had been treated for 9 years with etretinate (25 mg/d) in combination with several topical keratolytic agents. Despite this treatment, the patient still had a generalized erythema with a dry, pityriasiform

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