01547nas a2200265   4500000000100000008004100001260001300042653001500055653001200070653001300082653001100095653001200106653000900118653000900127653001600136100001300152700001600165700001600181700001600197245005900213300001000272490000700282520097800289022001401267       1981                            d  c1981 Jun10aAdolescent10aDapsone10aErythema10aHumans10aleprosy10aMale10aSkin10aThalidomide1 aFrey H M1 aGershon A A1 aBorkowsky W1 aBullock W E00aFatal reaction to dapsone during treatment of leprosy.  a777-90 v943 a<p>A Burmese boy being treated with dapsone (diaminodiphenylsulfone [DDS]), 100 mg daily, for lepromatous leprosy had a fatal reaction to the drug 3 weeks after therapy was started. The clinical symptoms and progression of illness conform well to a "DDS syndrome" first described in the early 1950s. Although the syndrome clinically resembles infectious mononucleosis, neither Epstein-Barr virus nor cytomegalovirus was implicated as an etiologic agent in this case. The syndrome has been recognized during initiation of dapsone therapy for lepromatous leprosy and has led to the use of a prolonged induction period with initial dosages as low as 25 mg/week. However, because dapsone resistance has been recognized in some strains of Mycobacterium leprae, slow induction of therapy has been replaced with the schedule used for this patient. This report of a fatal reaction to dapsone emphasizes the need for caution when initiating therapy with the drug at full dosage.</p>  a0003-4819