The dapsone hypersensitivity syndrome occurring in a patient with dermatitis herpetiformis

McKenna, Kevin E.; Robinson, J. W.

doi:10.1111/j.1365-2133.1997.tb03814.x

Cited by 13 publications

(5 citation statements)

References 7 publications

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“…The evaluation of such patients needs a complete work-up for the presence of systemic disease. Skin biopsy and immunofluorescence studies may also helpful in the diagnosis of cutaneous vasculitis in which immunoglobulin and complement deposition are found [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

The Dapsone Hypersensitivity Syndrome revisited: a potentially fatal multisystem disorder with prominent hepatopulmonary manifestations

Kosseifi

Guha

Nassour

et al. 2006

J Occup Med Toxicol

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4,4'-Diaminodiphenylsulphone (Dapsone) is widely used for a variety of infectious, immune and hypersensitivity disorders, with indications ranging from Hansen's disease, inflammatory disease and insect bites, all of which may be seen as manifestations in certain occupational diseases. However, the use of dapsone may be associated with a plethora of adverse effects, some of which may involve the pulmonary parenchyma. Methemoglobinemia with resultant cyanosis, bone marrow aplasia and/or hemolytic anemia, peripheral neuropathy and the potentially fatal dapsone hypersensitivity syndrome (DHS), the focus of this review, may all occur individually or in combination. DHS typically presents with a triad of fever, skin eruption, and internal organ (lung, liver, neurological and other systems) involvement, occurring several weeks to as late as 6 months after the initial administration of the drug. In this sense, it may resemble a DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms). DHS must be promptly identified, as untreated, the disorder could be fatal. Moreover, the pulmonary/systemic manifestations may be mistaken for other disorders. Eosinophilic infiltrates, pneumonitis, pleural effusions and interstitial lung disease may be seen. This syndrome is best approached with the immediate discontinuation of the offending drug and prompt administration of oral or intravenous glucocorticoids. An immunological-inflammatory basis of the syndrome can be envisaged, based on the pathological picture and excellent response to antiinflammatory therapy. Since dapsone is used for various indications, physicians from all specialties may encounter DHS and need to familiarize themselves with the salient features about the syndrome and its management.

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Section: Introductionmentioning

confidence: 99%

The Dapsone Hypersensitivity Syndrome revisited: a potentially fatal multisystem disorder with prominent hepatopulmonary manifestations

Kosseifi

Guha

Nassour

et al. 2006

J Occup Med Toxicol

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“…By virtue of its mechanism of action, dapsone is being increasingly used in many neutrophilic and other dermatoses and rheumatic conditions other than leprosy (4). The dapsone syndrome has been reported not only with leprosy but also with other varieties of dermatological conditions such as dermatitis herpetiformis, erythema elevatum diutinum, acne vulgaris, psoriasis, leukocytoclastic vasculitis, pemphigus, and lupus erythematosus from different parts of the world (5). It has also been reported in AIDS patients with pneumocystis carinii, because this drug is now routinely being used for prophylaxis against pneumocystis carinii (6).…”

Section: Introductionmentioning

confidence: 99%

Dapsone Hypersensitivity Syndrome: A Clinico-Epidemiological Review

Agrawal

Agarwalla

2005

The Journal of Dermatology

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Diaminodiphenyl sulphone (dapsone) is a drug of choice in the treatment of leprosy. It is also useful for the treatment of many neutrophilic and other dermatoses. Dapsone hypersensitivity syndrome is a rare but well recognized serious adverse effect characterized by fever, skin rashes, generalized lymphadenopathy, hepatitis, and hepato-splenomegaly. Twenty-six patients with dapsone hypersensitivity syndrome were studied for clinical profile, outcome, and prognosis. The male:female ratio was 2.2:1, and the mean age was 33.19 years (range 13 to 64 years). The interval between start of dapsone therapy and appearance of symptoms varied from 2-7 weeks (mean 29.82 days). Twenty-four patients received dapsone as a part of multi-drug therapy for leprosy; the other two patients received dapsone for lichen planus and acne vulgaris. Exfoliative dermatitis was the most common cutaneous manifestation followed by erythematous maculo-papular eruption and Stevens-Johnson syndrome-like lesion. The other common systemic manifestations were: fever (26 cases), itching (22 cases), lymphadenopathy (21 cases), jaundice (21 cases), pallor (20 cases), hepatomegaly (19 cases), and pedal edema (14 cases). Investigation profile revealed elevated levels of serum liver enzymes in 100% of patients, elevated erythrocyte sedimentation rate in 92.3%, raised bilirubin in 84.6%, leucocytosis in 69.23%, low hemoglobin (<9 gm/dl) in 46.15% and hypoproteinemia in 42.3%. Eosinophilia, hemolytic anemia, and reticulocytosis count were found in 4 patients each. All the patients had favorable outcomes except three who died due to hepatic failure. Medical personnel must be aware of this potentially fatal syndrome, because it can cause considerable morbidity and mortality.

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“…The side-effects are very low if plasma concentration of dapsone is below 5 mg/L. 18 In our patient rashes appeared by the end of 5 weeks.…”

Section: Discussionmentioning

confidence: 98%

A 50-Year-Old Male with Dapsone Hypersensitivity Syndrome

Khondker¹,

Wahab²,

Aslam³

2018

J Enam Med Col

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The dapsone hypersensitivity syndrome occurring in a patient with dermatitis herpetiformis

Cited by 13 publications

References 7 publications

The Dapsone Hypersensitivity Syndrome revisited: a potentially fatal multisystem disorder with prominent hepatopulmonary manifestations

The Dapsone Hypersensitivity Syndrome revisited: a potentially fatal multisystem disorder with prominent hepatopulmonary manifestations

Dapsone Hypersensitivity Syndrome: A Clinico-Epidemiological Review

A 50-Year-Old Male with Dapsone Hypersensitivity Syndrome

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