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 lymphadenopa thy, and later a widespread erythematous eruption studded with pustule s developed. She also had liver involvement with mixed hepatocellular and cholestatic features. The patient was treated with prednisone 60 m g daily. Once the patient's Liver function normalized, prednisone dosa ge was reduced by 5 mg weekly. The clinical features and treatment of DHS are reviewed. We encourage immediate discontinuation of the drug i n 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 possi ble risk of hypothyroidism.