TY - JOUR
KW - Dapsone hypersensitivity syndrome (DHS)
KW - Borderline tuberculoid leprosy
KW - Multi-drug therapy
KW - exfoliative dermatitis
KW - Adverse drug reactions
AU - Jindal A
AU - Alam R
AU - Goel S
AU - Chaudhary AF
AB - <p><strong>Background</strong></p>

<p>Dapsone is an essential component of multidrug therapy (MDT) for Hansen’s disease but is associated with rare, potentially life-threatening adverse events such as Dapsone Hypersensitivity Syndrome (DHS).</p>

<p><strong>Case</strong></p>

<p>We report a 67-year-old male with borderline tuberculoid leprosy who developed generalized exfoliative dermatitis, fever, eosinophilia, hepatosplenomegaly, and hypoxia three weeks after starting MDT. Cutaneous examination revealed diffuse skin exfoliation sparing old Hansen’s plaques, along with a trophic ulcer and nerve tenderness. Investigations showed leucocytosis, transaminitis, and CT scan findings consistent with hypersensitivity pneumonitis. MDT was withheld, and the patient was managed with systemic corticosteroids and oxygen support. Clinical and biochemical parameters improved, and MDT was reintroduced without dapsone under steroid cover.</p>

<p><strong>Conclusion</strong></p>

<p>DHS may mimic a Type&nbsp;1 lepra reaction, leading to diagnostic difficulty. Early recognition and prompt management are crucial to prevent severe complications. This case underscores the importance of considering DHS in patients presenting with systemic symptoms following dapsone initiation.</p>

BT - Leprosy Review
DO - 10.47276/lr.96.4.2025061
IS - 4
LA - ENG
M3 - Case Report
N2 - <p><strong>Background</strong></p>

<p>Dapsone is an essential component of multidrug therapy (MDT) for Hansen’s disease but is associated with rare, potentially life-threatening adverse events such as Dapsone Hypersensitivity Syndrome (DHS).</p>

<p><strong>Case</strong></p>

<p>We report a 67-year-old male with borderline tuberculoid leprosy who developed generalized exfoliative dermatitis, fever, eosinophilia, hepatosplenomegaly, and hypoxia three weeks after starting MDT. Cutaneous examination revealed diffuse skin exfoliation sparing old Hansen’s plaques, along with a trophic ulcer and nerve tenderness. Investigations showed leucocytosis, transaminitis, and CT scan findings consistent with hypersensitivity pneumonitis. MDT was withheld, and the patient was managed with systemic corticosteroids and oxygen support. Clinical and biochemical parameters improved, and MDT was reintroduced without dapsone under steroid cover.</p>

<p><strong>Conclusion</strong></p>

<p>DHS may mimic a Type&nbsp;1 lepra reaction, leading to diagnostic difficulty. Early recognition and prompt management are crucial to prevent severe complications. This case underscores the importance of considering DHS in patients presenting with systemic symptoms following dapsone initiation.</p>

PB - Lepra
PY - 2025
SP - 1
EP - 7
T2 - Leprosy Review
TI - Dapsone Hypersensitivity Syndrome with multisystem involvement in a case of Borderline Tuberculoid Hansen’s disease
UR - https://leprosyreview.org/article/96/4/20-25061
VL - 96
SN - 2162-8807
ER -