Dapsone hypersensitivity syndrome.
We describe a 22-year-old woman with cutaneous polyarteritis nodosa in whom dapsone hypersensitivity syndrome (DHS) developed 5 weeks after initiation of dapsone therapy. She had fever and cervical lymphadenopathy, and later a widespread erythematous eruption studded with pustules developed. She also had liver involvement with mixed hepatocellular and cholestatic features. The patient was treated with prednisone 60 mg daily. Once the patient's liver function normalized, prednisone dosage was reduced by 5 mg weekly. The clinical features and treatment of DHS are reviewed. We encourage immediate discontinuation of the drug in a patient in whom a fever or flu-like illness develops, especially 4 or more weeks after the treatment is started. We also suggest routine thyroid function testing 3 months after recovery because of the possible risk of hypothyroidism.
Prussick
R
R
Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Shear
N H
NH
D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury; D002779:Cholestasis / Q000139:chemically induced; D003622:Dapsone / Q000009:adverse effects*; D003879:Dermatologic Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D008206:Lymphatic Diseases / Q000139:chemically induced; D010488:Polyarteritis Nodosa / Q000188:drug therapy; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D003622:Dapsone; D011241:Prednisone