Sulfone Syndrome: A Unique Delayed Type of Drug Hypersensitivity from Dapsone

Authors

  • Metus Thungthienthong Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Nonthanat Tongsengkee Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Porntip Intapiboon Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.20241054

Keywords:

dapsone allergy, dapsone hypersensitivity syndrome, Sulfone syndrome

Abstract

Nowadays, dapsone is more commonly used in some dermatologic and inflammatory conditions other than leprosy. Even though it has excellent therapeutic efficacy, its side effects are of common concern. Although immune mediated drug hypersensitivity is less common, it can be fatal. Sulfone syndrome is a unique presentation that occurs in dapsone hypersensitivity syndrome (DHR). Here, we report on a 22-year-old female who was prescribed one month of dapsone for dermatitis. She developed a generalized maculopapular rash and low-grade fever and observed that her sclera had a yellowish discoloration. This case report demonstrates a unique character of delay-type drug hypersensitivity from dapsone, with the aim of increasing physician awareness when prescribing dapsone.

References

Allday EJ, Barnes J. Toxic effects of diaminodiphenylsulphone in treatment of leprosy. Lancet 1951;2:205-206. doi: 10.1016/s0140-6736(51)91443-2.

Richardus JH, Smith TC. Increased incidence in leprosy of hypersensitivity reactions to dapsone after introduction of multidrug therapy. Lepr Rev 1989;60:267-73. doi: 10.5935/0305-7518.19890033.

Sheen YS, Chu CY, Wang SH, Tsai TF. Dapsone hypersensitivity syndrome in non-leprosy patients: a retrospective study of its incidence in a tertiary referral center in Taiwan. J Dermatolog Treat 2009;20:340-3. doi: 10.3109/09546630802691317.

Agrawal S, Agarwalla A. dapsone hypersensitivity syndrome: aclinico-epidemiological review. J Dermatol 2005;32:883-9. doi: 10.1111/j.1346-8138.2005.tb00865.x.

Lorenz M, Wozel G, Schmitt J. Hypersensitivity reactions to dapsone: a systematic review. Acta Derm Venereol 2012;92:194-9. doi: 10.2340/00015555-1268.

Shen J, Liu M, Zhou M, Li W. Causes of death among active leprosy patients in China. Int J Dermatol 2011;50:57-60. doi: 10.1111/j.1365-4632.2010.04593.x.

Paniker U, Levine N. Dapsone and sulfapyridine. Dermatol Clin 2001;19:79-86. doi: 10.1016/s0733-8635(05)70231-x.

Wang N, Parimi L, Liu H, Zhang F. A review on dapsone hypersensitivity syndrome among chinese patients with an emphasis on preventing adverse drug reactions with genetic testing. Am J Trop Med Hyg 2017;96:1014-8. doi: 10.4269/ajtmh.16-0628.

Rao PN, Lakshmi TS. Increase in the incidence of dapsone hypersensitivity syndrome--an appraisal. Lepr Rev 2001;72:57-62. doi: 10.5935/0305-7518.20010009.

Danan G, Benichou C. Causality assessment of adverse reactions to drugs--I. A novel method based on the conclusions of international consensus meetings: application to druginduced liver injuries. J Clin Epidemiol 1993;46:1323-30. doi: 10.1016/0895-4356(93)90101-6.

Devarbhavi H, Raj S, Joseph T, Singh R, Patil M. Features and treatment of dapsone-induced hepatitis, based on analysis of 44 cases and literature review. Clin Gastroenterol Hepatol 2017;15:1805-7. doi: 10.1016/j.cgh.2017.05.031.

Zhu YI, Stiller MJ. Dapsone and sulfones in dermatology: overview and update. J Am Acad Dermatol 2001;45:420-4. doi: 10.1067/mjd.2001.114733.

Tempark T, Satapornpong P, Rerknimitr P, Nakkam N, Saksit N, Wattanakrai P, et al. Dapsone-induced severe cutaneous adverse drug reactions are strongly linked with HLA-B*13: 01 allele in the Thai population. Pharmacogenet Genomics 2017;27:429-37. doi: 10.1097/fpc.0000000000000306.

Satapornpong P, Pratoomwun J, Rerknimitr P, Klaewsongkram J, Nakkam N, Rungrotmongkol T, et al. HLA-B*13:01 is a predictive marker of dapsone-induced severe cutaneous adverse reactions in thai patients. Front Immunol 2021;12:661135. doi: 10.3389/fimmu.2021.661135.

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Published

2024-09-06

How to Cite

1.
Thungthienthong M, Tongsengkee N, Intapiboon P. Sulfone Syndrome: A Unique Delayed Type of Drug Hypersensitivity from Dapsone. J Health Sci Med Res [Internet]. 2024 Sep. 6 [cited 2024 Nov. 22];42(5):e20241054. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/273667

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Section

Case Report