Use of Mycophenolate Mofetil in Dermatology

Background: In the past two decades, many new small molecules with immunosuppressive properties have been developed to prevent allograft rejection to be used particularly after organ transplantation. During clinical investigation in these conditions some of these substances have been observed to provide therapeutic efficacy in inflammatory skin disorders, as well. Recently, mycophenolate mofetil which is derived from mycophenolic acid has been proven to be available in various inflammatory and autoimmune disorders of the skin because of its antitumoral, antibacterial and immunosuppressive properties. In the past two decades, an increasing number of immunosupressive new agents have been developed to prevent allograft rejection in organ transplantation. Some of these agents have been used in dermatology, because they have also been observed to provide therapeutic efficacy in inflammatory skin disorders. One of these agents is mycophenolate mofetil. Mycophenolate mofetil is a morpholino ester derived of an old drug, mycophenolic asid, which had been isolated from cultures of “Penicillium stoloniferum”. Mycophenolic asid, which is a lipid-soluble, weak organic asid, was shown to have antibacterial, antiviral, antifungal, antitumoral and immunosupressive properties [1]. In 1975, mycophenolic asid was used in treatment of psoriatic patients in dermatology. These studies have no longer been available because of its long term risk of carcinogenicity and gastrointestinal adverse effects whereas mycophenolate mofetil, a derivate of mycophenolic acid has been introduced. This new formulation showed enhanced bioavailability, tolerability and efficacy [1, 2]. By 1995, MMF received US FDA approval for the prevention of acute renal allograft rejection and soon became recognized as an effective treatment option for immune-mediated skin diseases.