An unusual case of dapsone hypersensitivity syndrome in a leprosy patient

Abstract

Dapsone (4, 4'-diamino-diphenyl sulfone, DDS) is a sulphone drug. Dapsone works through its antimicrobial and anti-inflammatory properties therefore it is useful for treating wide variety of infectious and inflammatory dermatological conditions including Hansen’s disease. Its low cost and easy availability in India, makes it more common in use by the clinicians. It has adverse side effects with usual common doses, and can cause skin, nervous system, gastrointestinal, hepatic, renal, pulmonary and hematological toxicities. Serious side effects may sometimes occur and may present as Steven-Johnson syndrome, toxic epidermal necrolysis or dapsone hypersensitivity syndrome (DHS). DHS is a severe idiosyncratic adverse reaction with multiorgan involvement. It is a rare side effect which occurs 5-6 weeks after initial administration of drug which sometimes results in an unpredictable outcome. Hereby, we report a case of severe, life threatening DHS in a 14-year-old female patient suffering from Hansen’s disease which was managed successfully with oral corticosteroids.