# Repurposing Historic Drugs for Neutrophil-Mediated Inflammation in Skin Disorders
## 3 Colchicine
### Neutrophil Dermatoses  
Colchicine is regarded as a viable treatment option for the treatment of Sweet syndrome according to a case report documenting the resolution of lesions with 0.5 mg of colchicine thrice daily by 1 week and to a retrospective analysis of 20 patients showing that 18 out of 20 patients experienced rapid symptom relief within 2-5 days on a daily dose of 1-1.5 mg [64]. Colchicine has been documented as an effective treatment for PG in small case series and case reports, particularly when other therapies have proven ineffective. Four documented cases of PG (two idiopathic and two associated with inflammatory bowel disease) demonstrated that a daily dose of 1-2 mg colchicine resulted in the resolution of lesions. However, the lack of prospective studies and randomized controlled trials (RCTs) leaves its efficacy unconfirmed. Colchicine may be considered an appropriate option for managing vasculitis, although available evidence provides mixed results. Colchicine has been used to treat cutaneous vasculitis, though its efficacy remains debated. The effect of the drug has been reported in LCV and in necrotizing vasculitis, but a randomized controlled trial by [PERSON] et al. did not find significant benefits of colchicine over topical emollients for LCV, and a multicentric trial (ARAMIS) is currently ongoing to evaluate and compare the efficacy of azathioprine, colchicine, and DDS in the treatment of isolated skin vasculitis [65]. Colchicine may be particularly useful in difficult-to-treat forms of psoriasis, such as pustular psoriasis and palmopl plantar pseudlosis. In treating PPP, the use of colchicine with daily doses of 1-2 mg resulted in partial or complete remission in 31 of 32 patients within 2-8 weeks. Additional studies have shown varying degrees of efficacy: in a double-blind, placebo-controlled trial, [PERSON] et al. observed significant improvement with 0.5 mg of colchicine administered three times daily over four weeks compared to a placebo. Despite these findings, a 2006 Cochrane review highlighted that while colchicine can be modestly beneficial, its use is often limited by a high incidence of gastrointestinal side effects [66]. [PERSON] et al. observed complete remission within two weeks in three out of four patients with pustular psoriasis treated with colchicine. Available evidence suggests that colchicine, particularly when used in combination with antibacterial agents, may represent an effective therapeutic option for the management of HS. Colchicine has been used in the treatment of HS with mixed results. A retrospective study by [PERSON] et al., which included 44 HS patients, demonstrated that colchicine, either as monotherapy or in combination with doxycycline, significantly improved both clinical severity and quality of life [67]. Similarly, a prospective open-label study treated 20 patients with a regimen of 100 mg of oral minocycline once daily and 0.5 mg of colchicine twice daily for 6 months, followed by a 3-month maintenance phase with colchicine alone. All patients showed clinical improvement after 3 months, with further progress observed over time [68]. However, conflicting findings exist, such as the study by [PERSON] et al., which found no clinical improvement in 8 HS patients treated with 0.5 mg of colchicine twice daily for up to 4 months, despite notable gastrointestinal side effects [69]. Colchicine has demonstrated effectiveness in both [PERSON]'s syndrome and recurrent aphthous stomatitis (RAS). For [PERSON]'s syndrome, a double-blind clinical trial showed that 1.5 mg of colchicine daily significantly reduced erythema nodosum and arthralgias. In a clinical trial by [PERSON] et al., colchicine was found to be as effective as cyclosporine in symptom control, making it a safer and more affordable option for [PERSON]'s syndrome. In RAS, a study by [PERSON] et al. reported that colchicine at 0.5 mg administered three times daily led to a marked reduction in pain and ulcer count, with a 77% pain reduction and 71% decrease in ulcers [70].