Review of the Use of Fumaric Acid Esters in Dermatology

Background: Fumaric acid esters (FAE) have been used as a drug since 1959. The therapeutic preparation containing FAE has been one of the prominent drugs used for the systemic treatment of psoriasis since 1994 in Germany. FAE have been used in the treatment of sarcoidosis, granuloma annulare, necrobiosis lipoidica, cheilitis granulomatosa, annular elastotic giant cell granuloma, malignant melanoma, pityriasis rubra pilaris, alopecia areata, hidradenitis suppurativa, and lupus erythematosus with different success rates. The results obtained from research articles, case reports or case series of the used FAE of dermatological diseases were revised in this article. FAE can be an effective and safe first-line treatment alternative in the treatment of psoriasis. It also can be beneficial to granulomatous skin diseases, lupus erythematosus, malignant melanoma, pityriasis rubra pilaris, alopecia areata, and hidradenitis suppurativa in patients unresponsive to first line therapies.