02502nas a2200217   4500000000100000008004100001260001000042653001200052653002000064653004400084653002100128653002900149100001000178700001300188700001300201700001200214245018100226856006300407520178900470022002502259       2025                            d  bWiley10aDapsone10aAdverse effects10aDapsone hypersensitivity syndrome (DHS)10aLeprosy patients10aMulti drug therapy (MDT)1 aDev A1 aNarang T1 aThakur V1 aDogra S00aThe Dapsone Conundrum: Understanding Implications of Adverse Reactions to Dapsone Including Dapsone Hypersensitivity Syndrome in Leprosy Patients Treated With Multidrug Therapy  uhttps://onlinelibrary.wiley.com/doi/epdf/10.1111/ijd.179063 a<p><strong>Background</strong> The introduction of the World Health Organization's multidrug therapy (WHO‐MDT) has significantly advanced leprosy treatment. Although dapsone is a fundamental component of MDT, it presents risks of adverse drug reactions (ADR), including the potentially fatal dapsone hypersensitivity syndrome (DHS).</p>

<p><strong>Methods </strong>Consequently, we conducted a retrospective observational study by reviewing the records of patients registered at the leprosy clinic within the department of dermatology at a tertiary care center from 2010 to 2022. We included all patients who experienced ADR due to dapsone that necessitated its discontinuation, with particular emphasis on those who developed DHS.</p>

<p><strong>Results </strong>Among 1598 leprosy patients treated with standard WHO‐MDT, 45 patients developed ADR requiring cessation of dapsone (2.82% over 12 years). The most common ADR was abnormal liver function tests in 14 patients (0.87%) and anemia in 13 patients (0.81%), including one case each of hemolytic anemia and methemoglobinemia. Neuropsychiatric adverse effects were observed in five patients (0.31%). The incidence of DHS was 0.75% (12 patients), with maculopapular rash being the most frequent cutaneous manifestation. These patients were subsequently treated with MDT without dapsone, along with standard care for the ADR, resulting in no mortality or serious morbidity.</p>

<p><strong>Conclusion</strong> While dapsone remains a cornerstone in the treatment of leprosy, the potential for clinically significant though infrequent adverse reactions highlights the need for vigilant monitoring and increased awareness among healthcare providers of the diverse manifestations of dapsone‐related side effects.</p>
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